Correlation of Demographic Characteristics to Bone Calcium and Vitamin D in Patient taking Proton Pump Inhibitor (PPI): Demographics and Bone Health in Proton Pump Inhibitor Users

Yasra Memon; Imran Ali Shaikh; Imran Karim; Tariq Zaffar Shaikh

doi:10.54393/pjhs.v5i04.1251

Authors

Yasra Memon Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Imran Ali Shaikh Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Imran Karim Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Tariq Zaffar Shaikh Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i04.1251

Keywords:

Proton Pump Inhibitors, Serum Calcium, Serum Vitamin D, Acid peptic disease, Dyspepsia

Abstract

Proton pump inhibitor (PPI) works by blocking the hydrogen-potassium ATPase inhibitor H/K ATPase inhibitor located on gastric parietal cells. It blocks the last step of acid production that is why it is more potent and effective than other acid suppressants like H2 blockers, 99% of gastric acid secretion is reduced by using it. Objective: To evaluate Demographic characteristics of individuals using proton pump inhibitor (PPI) all over Sindh. Methods: The Quasi experimental study contained 227 young individuals of age 20-45years having acid peptic disease, dyspepsia. Study was taken place in Medicine OPDs of Jamshoro and Hyderabad at Civil Hospital and duration of study was from 15^th March 2020 to 15^th September 2020. All individuals taking proton pump inhibitor were excluded from study. Sampling technique was non-probability convenient sampling. SPSS version 21.0 software was used to analyze the data. The student paired t test was used at the confidence interval of 95%, apart from it the P-value is observed ≤ 0.05. Results: There was no effect on demographic characteristics of individuals using proton pump inhibitor (PPI) all over Sindh on serum calcium and vitamin D levels. Therefore, p-value was seen 0.7 for the serum calcium and 0.1 for Serum Vitamin D. Conclusions: In any group of age, gender, residential status there is no effect on serum calcium and vitamin D with use of proton pump inhibitor (PPI) for less than 6 months.

References

DeLuca HF. Overview of general physiologic features and functions of vitamin D. The American Journal of Clinical Nutrition. 2004 Dec; 80(6): 1689S-96S. doi: 10.1093/ajcn/80.6.1689S. DOI: https://doi.org/10.1093/ajcn/80.6.1689S

Wasserman RH. Vitamin D and intestinal absorption of calcium: a view and overview. In: P JW, Feldman D, Glorieux F, editors. Vitamin D. Acedemin Press; San Diego, CA. 2005; 1: 411-428. doi: 10.1016/B978-012252687-9/50027. DOI: https://doi.org/10.1016/B978-012252687-9/50027-9

Del Valle HB, Yaktine AL, Taylor CL, Ross AC, editors. Dietary reference intakes for calcium and vitamin D. 2011: 1132. doi: 10.17226/13050. DOI: https://doi.org/10.17226/13050

Benn BS, Ajibade D, Porta A, Dhawan P, Hediger M, Peng JB et al. Endocrinology. 2008 Jun; 149(6): 3196-205. doi: 10.1210/en.2007-1655. DOI: https://doi.org/10.1210/en.2007-1655

Allgrove J. Disorders of calcium metabolism. Current Pediatrics. 2003 Dec; 13(7): 529-35. doi: 10.1016/j.cupe.2003.08.007. DOI: https://doi.org/10.1016/j.cupe.2003.08.007

Van Vliet EP, Otten HJ, Rndolplus A, Knoester PD, Hoogsteden HC, Kuipers EJ, et al. Inappropriate prescription of proton-pump inhibitors on two pulmonary medicine wards. For J Gastroenterol Hepatol 2008; 20: 608-19. doi:10.1097/MEG.0b013e3282f52f95. DOI: https://doi.org/10.1097/MEG.0b013e3282f52f95

Shafi S, Soomro R, Abbas SZ. Proton pump inhibitors–overprescribed in a rural community. Pakistan Journal of Medical Sciences. 2011 Apr; 27(2): 300-2.

Abbas Naqvi SH, Mohammad Saqib S, Ahmad Khan W, Asim Syed IA. Rising Use Of Proton Pump Inhibitors: A Karachi Perspective. Science International. 2014 Nov; 26(5).

Haroon M, Yasin F, Gardezi SK, Adeeb F, Walker F. Inappropriate use of proton pump inhibitors among medical inpatients: a questionnaire-based observational study. Journal of the Royal Society of Medicine short reports. 2013 Jun; 4(8): 2042533313497183. doi: 10.1177/2042533313497183. DOI: https://doi.org/10.1177/2042533313497183

Memon Y, Shaikh IA, Karim I. Quasi Experimental Study to Ascertain Link of PPI to Bone Profile in Healthy Individuals: Link of PPI to Bone Profile. Pakistan Journal of Health Sciences. 2023 Sep: 89-92. doi: 10.54393/pjhs.v4i09.1039. DOI: https://doi.org/10.54393/pjhs.v4i09.1039

Christakos S, Dhawan P, Porta A, Mady LJ, Seth T. Vitamin D and intestinal calcium absorption. Molecular and cellular endocrinology. 2011 Dec; 347(1-2): 25-9. doi :10.1016/j.mce.2011.05.038. DOI: https://doi.org/10.1016/j.mce.2011.05.038

Tuukkanen J and Vaananen HK. Omeprazole, a specific inhibitor of H+-K+-ATPase, inhibits bone resorption in vitro. Calcified Tissue International. 1986; 38:123-5. doi: 10.1007/BF02556841. DOI: https://doi.org/10.1007/BF02556841

Kwok CS, Yeong JK, Loke YK. Meta-analysis: risk of fractures with acid-suppressing medication. Bone 2011; 48:768-76. doi: 10.1016/j.bone.2010.12.015. DOI: https://doi.org/10.1016/j.bone.2010.12.015

Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB et al. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010 Mar; 65(3): 225-36. doi: 10.1016/j.maturitas.2009.12.013. DOI: https://doi.org/10.1016/j.maturitas.2009.12.013

William M and Pounder RE. An audit of proton-pump inhibitor usage in a teaching hospital setting 1997; 40: A59.

Elaine WY, Bauer SR, Bain PA, Bauer DC. Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies. The American journal of medicine. 2011 Jun; 124(6): 519-26. doi: 10.1016/j.amjmed.2011.01.007. DOI: https://doi.org/10.1016/j.amjmed.2011.01.007

Wright MJ, Sullivan RR, Gaffney-Stomberg E. Inhibiting gastric acid production does not affect intestinal calcium absorption in young, healthy individuals: a randomized, crossover, controlled clinical trial. Journal of Bone and Mineral Research. 2010; 25: 2205–11. doi: 10.1002/jbmr.108. DOI: https://doi.org/10.1002/jbmr.108

Sharara All. El-Halabi MM, Ghaith OA, Habib RH. Proton pump inhibitors have no measurable effect on calcium and bone metabolism in healthy young males: a prospective matched controlled study. Metabolism 2013; 62(4): 518-26. doi: 10.1016/j.metabol.2012.09.011. DOI: https://doi.org/10.1016/j.metabol.2012.09.011

Serfaty-Lacrosniere C, Wood RJ, Voytko D. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium or zinc from food in humans. Journal of the American College of Nutrition. 1995; 14:364–8. doi: 10.1080/07315724.1995.10718522. DOI: https://doi.org/10.1080/07315724.1995.10718522

Paiva SA, Sepe TE, Booth SL, Camilo ME, O’Brien ME, Davidson KW et al. Interaction between vitamin K nutriture and bacterial overgrowth in hypochlorhydria induced by omeprazole. The American Journal of Clinical Nutrition. 1998 Sep; 68(3): 699-704. doi: 10.1093/ajcn/68.3.699. DOI: https://doi.org/10.1093/ajcn/68.3.699