Use of proton pump inhibitors and increased risk of fracture in type 2 DM and menopausal women: a systematic review and meta-analysis
Abstract
Objective: To investigate the relationship between type 2 diabetes mellitus and postmenopausal women with fracture risk when using PPIs.
Methods: We conducted an observational study to investigate the association between PPI use and an increased fracture risk in postmenopausal women and type 2 diabetes mellitus. We searched for epidemiological studies published between 2006 and 2023 in PubMed, Google Scholar, and other bibliographies of the retrieved papers. The pooled OR was obtained using the random-effects model, and a subgroup analysis was conducted.
Results: Eight studies, including six cohorts and two case-control studies, were conducted with 1.3 million participants. In these studies, 1,63,346 cases of fracture risk were identified. The pooled effect estimate of these studies was OR 1.61, with a 95% CI of 1.36-1.90. This indicates a significant correlation between Type 2 diabetes mellitus, post-menopausal women, and the risk of fractures. The OR for type 2 DM alone was 1.34 (95% CI 1.14-1.57), and for menopausal women alone, the OR was 2.15 (95% CI 1.36-1.90). Notably, there was no evidence of publication bias.
Conclusion: This meta-analysis provides strong evidence that PPI use in type 2 DM and menopausal women is significantly associated with the risk of developing fractures.
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.
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