Proton pump inhibitors have no measurable effect on calcium and bone metabolism in healthy young males: A prospective matched controlled study

Abstract

Objectives: Proton pump inhibitors (PPIs) are associated with an increased risk of bone fractures. This study sought to evaluate the effect of PPIs on biochemical markers of calcium and bone metabolism. Methods: Prospective matched controlled study involving healthy adult males (age 18-50 years) suffering from frequent heartburn. Patients received standard-dose PPI for 12 weeks and were matched by age with healthy controls. Blood studies were taken at 0, 1 and 3 months for biochemical markers of mineral and bone metabolism. Two-way (time and PPI treatment) repeated measures analysis of variance (RM-ANOVA) and multiple linear regression were used for analysis. Results: A total of 58 participants (29 per group) completed the study. Mean age of participants was 33.2 ± 7.5 years. Baseline characteristics and biomarkers were similar for both groups except for higher BMI (28.6 vs. 25.6 kg-m2, p = 0.008) and serum C-terminal cross linked telopeptides of type I collagen [CrossLaps, (300 vs. 228 pg-ml, p = 0.028)] in the PPI group. There was no difference in parathormone (PTH), ionized calcium, vitamin D, osteocalcin and CrossLaps between the PPI and control subjects (all non-significant; 2-way RM-ANOVA). Multiple linear regression modeling showed no effect of PPIs on any of the studied calcium or bone metabolism biomarkers. Conclusion: PPI intake for 12 weeks has no measurable effect on calcium or bone metabolism in healthy young males. © 2013 Elsevier Inc.