Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women. The WHILA study

• Published in: Maturitas Vol. 78; no. 4; pp. 310 - 315
• Main Authors: Moberg, Louise M.E, Nilsson, Peter M, Samsioe, Göran, Borgfeldt, Christer
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-08-2014; Elsevier
• Subjects: Biological and medical sciences; Bone Density; Bone mineral density (BMD); Clinical Medicine; Diabetes Mellitus; Estrogen Replacement Therapy; Female; Fracture risk; Fractures, Bone - complications; Gynecology. Andrology. Obstetrics; Humans; Internal Medicine; Klinisk medicin; Logistic Models; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Obstetrics and Gynecology; Obstetrics, Gynecology and Reproductive Medicine; Odds Ratio; Osteoporosis, Postmenopausal - complications; Osteoporotic Fractures - etiology; Postmenopausal women; Postmenopause; Previous fracture; Protective Factors; Proton pump inhibitors (PPI); Proton Pump Inhibitors - adverse effects; Puberal and climacteric disorders (male and female); Registries; Reproduktionsmedicin och gynekologi; Risk Factors; Surveys and Questionnaires; progestogen-only contraception; POC; SOEBIL; PPI; Bone mineral density (BMD); Postmenopausal women; DXA; Fracture risk; postmenopausal where menstruations have ceased for more than 12 months ago; proton pump inhibitors; SSRI; Previous fracture; PMO; COC; PMT; selective serotonin reuptake inhibitors; Proton pump inhibitors (PPI); bilateral salpingoophorectomy; peri- and postmenopausal women with current hormone therapy; dual X-ray absorptiometry; combined oral contraceptives; Human; Menopause; Diseases of the osteoarticular system; Antiulcer agent; Fracture; Trauma; Proton pump inhibitor; Antisecretory agent; Risk factor; Female; Bone mineral density; Woman
• ISSN: 0378-5122; 1873-4111; 1873-4111
• DOI: 10.1016/j.maturitas.2014.05.019

Abstract Postmenopausal women in the Western world are highly burdened by osteoporotic fractures. The aim of this study is to investigate risk factors at baseline for fracture in 6416 postmenopausal women during long-term follow-up. At baseline, all women completed a questionnaire regarding background factors, diseases, current use of medications and reproductive and contraceptive history, a physical examination and laboratory analyses. Fracture occurrence after inclusion in the study was recorded with the help of official registries. All significant variables in univariate logistic regression with a decreased or increased risk for fracture were analysed in a multivariate logistic regression. Increased fracture risk was observed in women currently using proton pump inhibitors (PPI), odds ratio (OR) 2.53 (95% confidence interval (CI)) 1.28–4.99, and women having had a fracture after the age of 40, but before inclusion in the study, OR 1.70 (95% CI 1.24–2.32). A protective effect against fractures was observed in women with a positive family history of diabetes OR 0.66 (95% CI 0.44–0.98). A significant interaction was observed between fracture risk, use of PPI and HT status ( p = 0.014) and women with HT had an increased fracture risk with use of PPI (OR 3.37 (95% CI 1.96–5.80)) compared to women without HT (OR 1.13 (95% CI 0.57–2.24)). In conclusion, usage of PPIs was associated with a doubled risk for fracture in postmenopausal women. Women with previous fractures using PPI should be considered for prophylactic treatment reducing fracture risk.