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KMID : 1188320150090050607
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Gut and Liver
2015 Volume.9 No. 5 p.607 ~ p.614
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A Proton Pump Inhibitor’s Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study
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Jo Yun-ju
Park Eun-kyoung
Ahn Sang-Bong
Jo Young-Kwan
Son Byung-kwan
Kim Seong-Hwan
Park Young-Sook
Kim Hyo-Jeong
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Abstract
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Background/Aims:Proton pump inhibitors (PPIs) act by irreversibly binding to the H+-K+-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H+-ATPase in osteoclasts.
Methods:We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H+-K+-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period.
Results:Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD.
Conclusions:In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H+-ATPase in osteoclasts.
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KEYWORD
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Bone metabolism, Hydrogen potassium ATPase, Osteoclasts, Osteoporosis, Proton pump inhibitors
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