The Effect of Proton Pump Inhibitors on Bone Mineral Density at Specific Anatomical Sites: A Systematic Review and Meta-Analysis
Abstract
There have been some concerns about the potential adverse consequences of proton pump inhibitors (PPIs) on bone health, specifically with respect to bone mineral density (BMD). The objective of the present investigation was to evaluate the impact of PPIs on BMD in the lumbar spine, femoral neck, and total hip regions. On the basis of PRISMA, a systematic review and meta‐analysis were performed. PubMed, Scopus, Cochrane Library, and Google Scholar were used to find eligible observational studies published between January 2010 and January 2025. The ROBINS‐I tool was employed to evaluate potential for bias, and studies with critical bias were excluded. To synthesize the data, random‐effects models were utilized, and the I 2 statistic was used to evaluate heterogeneity. The sensitivity analyses and publication bias were also performed. A systematic review and quantitative synthesis used 20 and seven records, respectively, of 170 records screened. The comprehensive pooled analysis revealed that the decrease in BMD with the use of PPIs was modest yet statistically significant (SMD −0.15, 95% CI −0.21 to 0.09) alongside a substantial degree of heterogeneity ( I 2 = 93.6 % ). Subgroup analysis demonstrated that there were significant decreases at the femoral neck (SMD −0.27, 95% CI −0.46 to −0.09), but not at the lumbar spine or the total hip. The funnel plot analysis indicated a certain level of asymmetry, and the sensitivity analysis indicated that the results were mostly robust;…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.