PDF(Pubmed)
Abstract：
UNASSIGNED: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide for acid-related disorders. While their short-term efficacy and safety are well-established, concerns regarding their long-term effects on bone health have emerged. This umbrella review aimed to synthesize the available findings on the associations between PPI use and bone metabolism outcomes.
UNASSIGNED: An electronic search was conducted using PubMed, Web of Science, Embase, and the Cochrane Database up to September 16, 2023. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) and observational studies that evaluated the relationship between PPIs and bone metabolism outcomes were included. Data extraction, quality appraisal, and synthesis were performed in line with the Joanna Briggs Institute and PRISMA guidelines. The strength of the evidence was graded using the GRADE criteria. Statistical analysis was performed in R version 4.3.
UNASSIGNED: Out of 299 records, 27 studies met the inclusion criteria. The evidence indicated a statistically significant increased risk of fractures, notably hip, spine, and wrist fractures, in PPI users. PPI use was associated with changes in Bone Mineral Density (BMD) across various bones, though the clinical relevance of these changes remains uncertain. Furthermore, PPI-induced hypomagnesemia, which can influence bone health, was identified. A notable finding was the increased risk of dental implant failures in PPI users. However, the certainty of most of the evidence ranged from very low to low based on GRADE criteria.
UNASSIGNED: The long-term use of PPIs may be associated with adverse bone health outcomes, including increased fracture risk, alterations in BMD, hypomagnesemia, and dental implant failure. While these findings highlight potential concerns for long-term PPI users, the current evidence\'s low certainty underscores the need for robust, high-quality research to clarify these associations.
UNASSIGNED: An electronic search was conducted using PubMed, Web of Science, Embase, and the Cochrane Database up to September 16, 2023. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) and observational studies that evaluated the relationship between PPIs and bone metabolism outcomes were included. Data extraction, quality appraisal, and synthesis were performed in line with the Joanna Briggs Institute and PRISMA guidelines. The strength of the evidence was graded using the GRADE criteria. Statistical analysis was performed in R version 4.3.
UNASSIGNED: Out of 299 records, 27 studies met the inclusion criteria. The evidence indicated a statistically significant increased risk of fractures, notably hip, spine, and wrist fractures, in PPI users. PPI use was associated with changes in Bone Mineral Density (BMD) across various bones, though the clinical relevance of these changes remains uncertain. Furthermore, PPI-induced hypomagnesemia, which can influence bone health, was identified. A notable finding was the increased risk of dental implant failures in PPI users. However, the certainty of most of the evidence ranged from very low to low based on GRADE criteria.
UNASSIGNED: The long-term use of PPIs may be associated with adverse bone health outcomes, including increased fracture risk, alterations in BMD, hypomagnesemia, and dental implant failure. While these findings highlight potential concerns for long-term PPI users, the current evidence\'s low certainty underscores the need for robust, high-quality research to clarify these associations.
摘要：
■质子泵抑制剂（PPIs）是世界范围内用于酸相关疾病的最常用的处方药之一。虽然它们的短期疗效和安全性是公认的，关于它们对骨骼健康的长期影响的担忧已经出现。这篇综述旨在综合PPI使用与骨代谢结果之间关联的现有发现。
■使用PubMed进行了电子搜索，WebofScience,Embase,以及截至2023年9月16日的Cochrane数据库。纳入随机对照试验（RCT）和观察性研究的系统评价和荟萃分析，这些研究评估了PPI与骨代谢结果之间的关系。数据提取,质量评估，和合成是按照JoannaBriggs研究所和PRISMA指南进行的。使用等级标准对证据的强度进行分级。在R版本4.3中进行统计学分析。
■在299条记录中，27项研究符合纳入标准。证据表明骨折的风险显著增加，特别是臀部，脊柱,和手腕骨折,在PPI用户中。PPI使用与各种骨骼的骨矿物质密度（BMD）变化有关，尽管这些变化的临床相关性仍不确定。此外，PPI诱导的低镁血症，会影响骨骼健康，已确定。一个值得注意的发现是PPI使用者牙种植体失败的风险增加。然而,根据GRADE标准,大部分证据的确定性从非常低到低不等.
■长期使用PPI可能与骨骼健康不良结果有关，包括骨折风险增加，BMD的改变，低镁血症,和牙种植失败。虽然这些发现凸显了长期PPI用户的潜在担忧，当前证据的低确定性强调了对稳健的需求，高质量的研究来澄清这些关联。
■使用PubMed进行了电子搜索，WebofScience,Embase,以及截至2023年9月16日的Cochrane数据库。纳入随机对照试验（RCT）和观察性研究的系统评价和荟萃分析，这些研究评估了PPI与骨代谢结果之间的关系。数据提取,质量评估，和合成是按照JoannaBriggs研究所和PRISMA指南进行的。使用等级标准对证据的强度进行分级。在R版本4.3中进行统计学分析。
■在299条记录中，27项研究符合纳入标准。证据表明骨折的风险显著增加，特别是臀部，脊柱,和手腕骨折,在PPI用户中。PPI使用与各种骨骼的骨矿物质密度（BMD）变化有关，尽管这些变化的临床相关性仍不确定。此外，PPI诱导的低镁血症，会影响骨骼健康，已确定。一个值得注意的发现是PPI使用者牙种植体失败的风险增加。然而,根据GRADE标准,大部分证据的确定性从非常低到低不等.
■长期使用PPI可能与骨骼健康不良结果有关，包括骨折风险增加，BMD的改变，低镁血症,和牙种植失败。虽然这些发现凸显了长期PPI用户的潜在担忧，当前证据的低确定性强调了对稳健的需求，高质量的研究来澄清这些关联。
