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Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies

BACKGROUND: Previous meta-analyses have suggested that there might be an association between the use of proton pump inhibitors (PPIs) and the development of hypomagnesemia, although the conclusions were no definitive. METHODS: To provide an update on this topic, we performed a meta-analysis of all o...

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Autores principales: Srinutta, Thawin, Chewcharat, Api, Takkavatakarn, Kullaya, Praditpornsilpa, Kearkiat, Eiam-Ong, Somchai, Jaber, Bertrand L., Susantitaphong, Paweena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946416/
https://www.ncbi.nlm.nih.gov/pubmed/31689852
http://dx.doi.org/10.1097/MD.0000000000017788
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author Srinutta, Thawin
Chewcharat, Api
Takkavatakarn, Kullaya
Praditpornsilpa, Kearkiat
Eiam-Ong, Somchai
Jaber, Bertrand L.
Susantitaphong, Paweena
author_facet Srinutta, Thawin
Chewcharat, Api
Takkavatakarn, Kullaya
Praditpornsilpa, Kearkiat
Eiam-Ong, Somchai
Jaber, Bertrand L.
Susantitaphong, Paweena
author_sort Srinutta, Thawin
collection PubMed
description BACKGROUND: Previous meta-analyses have suggested that there might be an association between the use of proton pump inhibitors (PPIs) and the development of hypomagnesemia, although the conclusions were no definitive. METHODS: To provide an update on this topic, we performed a meta-analysis of all observational studies that examined the association between the use of PPIs and the development of hypomagnesemia. A literature search was conducted in MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (January 1970 to June 2018) to identify observational studies that examined the association between the use of PPIs and the incidence and prevalence of hypomagnesemia. STUDY ELIGIBILITY CRITERIA: In the absence of randomized controlled trials, we focused primarily on observational studies, including cross-sectional, case-control, retrospective, and prospective cohort studies. There was no limitation on sample size or study duration. Random-effect models meta-analyses were used to compute pooled unadjusted and adjusted odds ratios (ORs) for binary variables. RESULTS: Sixteen observational studies were identified, including 13 cross-sectional studies, 2 case-control studies, and 1 cohort study, with a total of 131,507 patients. The pooled percentage of PPI users was 43.6% (95% confidence interval [CI] 25.0%, 64.0%). Among PPI users, 19.4% (95% CI 13.8%, 26.5%) had hypomagnesemia compared to 13.5% (95% CI 7.9%, 22.2%) among nonusers. By meta-analysis, PPI use was significantly associated with hypomagnesemia, with a pooled unadjusted OR of 1.83 (95% CI 1.26, 2.67; P = .002) and a pooled adjusted OR of 1.71 (95% CI 1.33, 2.19; P < .001). In subgroup analyses, high-dose PPI use was associated with higher odds for hypomagnesemia relative to low-dose PPI use (pooled adjusted OR 2.13; 95% CI 1.26, 3.59; P = .005). CONCLUSION: Our findings are in support of the results of the previous meta-analyses. Furthermore, we found a dose-response between the PPI use and development of hypomagnesemia.
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spelling pubmed-69464162020-01-31 Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies Srinutta, Thawin Chewcharat, Api Takkavatakarn, Kullaya Praditpornsilpa, Kearkiat Eiam-Ong, Somchai Jaber, Bertrand L. Susantitaphong, Paweena Medicine (Baltimore) 5200 BACKGROUND: Previous meta-analyses have suggested that there might be an association between the use of proton pump inhibitors (PPIs) and the development of hypomagnesemia, although the conclusions were no definitive. METHODS: To provide an update on this topic, we performed a meta-analysis of all observational studies that examined the association between the use of PPIs and the development of hypomagnesemia. A literature search was conducted in MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (January 1970 to June 2018) to identify observational studies that examined the association between the use of PPIs and the incidence and prevalence of hypomagnesemia. STUDY ELIGIBILITY CRITERIA: In the absence of randomized controlled trials, we focused primarily on observational studies, including cross-sectional, case-control, retrospective, and prospective cohort studies. There was no limitation on sample size or study duration. Random-effect models meta-analyses were used to compute pooled unadjusted and adjusted odds ratios (ORs) for binary variables. RESULTS: Sixteen observational studies were identified, including 13 cross-sectional studies, 2 case-control studies, and 1 cohort study, with a total of 131,507 patients. The pooled percentage of PPI users was 43.6% (95% confidence interval [CI] 25.0%, 64.0%). Among PPI users, 19.4% (95% CI 13.8%, 26.5%) had hypomagnesemia compared to 13.5% (95% CI 7.9%, 22.2%) among nonusers. By meta-analysis, PPI use was significantly associated with hypomagnesemia, with a pooled unadjusted OR of 1.83 (95% CI 1.26, 2.67; P = .002) and a pooled adjusted OR of 1.71 (95% CI 1.33, 2.19; P < .001). In subgroup analyses, high-dose PPI use was associated with higher odds for hypomagnesemia relative to low-dose PPI use (pooled adjusted OR 2.13; 95% CI 1.26, 3.59; P = .005). CONCLUSION: Our findings are in support of the results of the previous meta-analyses. Furthermore, we found a dose-response between the PPI use and development of hypomagnesemia. Wolters Kluwer Health 2019-11-01 /pmc/articles/PMC6946416/ /pubmed/31689852 http://dx.doi.org/10.1097/MD.0000000000017788 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5200
Srinutta, Thawin
Chewcharat, Api
Takkavatakarn, Kullaya
Praditpornsilpa, Kearkiat
Eiam-Ong, Somchai
Jaber, Bertrand L.
Susantitaphong, Paweena
Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title_full Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title_fullStr Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title_full_unstemmed Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title_short Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies
title_sort proton pump inhibitors and hypomagnesemia: a meta-analysis of observational studies
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946416/
https://www.ncbi.nlm.nih.gov/pubmed/31689852
http://dx.doi.org/10.1097/MD.0000000000017788
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