The Effects of Proton Pump Inhibitors in Acid Hypersecretion-Induced Vitamin B12 Deficiency: A Systematic Review (2022)

Swarnakari, Kiran Maee; Bai, Meena; Manoharan, Mohana Priya; Raja, Rabab; Jamil, Aneeque; Csendes, Denise; Gutlapalli, Sai Dheeraj; Prakash, Keerthana; Desai, Darshi M; Desai, Aditya; Khan, Safeera

doi:10.7759/cureus.31672

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…We see an exceptionally high prevalence of proton pump inhibitors in cardiometabolic patterns. It has been reported that this group of gastroprotectors can reduce the absorption of vitamin B12, potentially resulting in vitamin B12 deficiency ( 85 , 86 ). A possible increase in homocysteine could lead to a higher risk of cardiovascular complications ( 87 , 88 ), such as thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study

Ioakeim-Skoufa,

González-Rubio,

Aza-Pascual-Salcedo

et al. 2024

Front. Public Health

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IntroductionThe presence of multiple chronic conditions, also referred to as multimorbidity, is a common finding in adults. Epidemiologic research can help identify groups of individuals with similar clinical profiles who could benefit from similar interventions. Many cross-sectional studies have revealed the existence of different multimorbidity patterns. Most of these studies were focused on the older population. However, multimorbidity patterns begin to form at a young age and can evolve over time following distinct multimorbidity trajectories with different impact on health. In this study, we aimed to identify multimorbidity patterns and trajectories in adults 18–65 years old.MethodsWe conducted a retrospective longitudinal epidemiologic study in the EpiChron Cohort, which includes all inhabitants of Aragón (Spain) registered as users of the Spanish National Health System, linking, at the patient level, information from electronic health records from both primary and specialised care. We included all 293,923 patients 18–65 years old with multimorbidity in 2011. We used cluster analysis at baseline (2011) and in 2015 and 2019 to identify multimorbidity patterns at four and eight years of follow-up, and we then created alluvial plots to visualise multimorbidity trajectories. We performed age- and sex-adjusted logistic regression analysis to study the association of each pattern with four- and eight-year mortality.ResultsWe identified three multimorbidity patterns at baseline, named dyslipidaemia & endocrine-metabolic, hypertension & obesity, and unspecific. The hypertension & obesity pattern, found in one out of every four patients was associated with a higher likelihood of four- and eight-year mortality (age- and sex-adjusted odds ratio 1.11 and 1.16, respectively) compared to the unspecific pattern. Baseline patterns evolved into different patterns during the follow-up.DiscussionWell-known preventable cardiovascular risk factors were key elements in most patterns, highlighting the role of hypertension and obesity as risk factors for higher mortality. Two out of every three patients had a cardiovascular profile with chronic conditions like diabetes and obesity that are linked to low-grade systemic chronic inflammation. More studies are encouraged to better characterise the relatively large portion of the population with an unspecific disease pattern and to help design and implement effective and comprehensive strategies towards healthier ageing.

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Section: Discussionmentioning

confidence: 99%

Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study

Ioakeim-Skoufa,

González-Rubio,

Aza-Pascual-Salcedo

et al. 2024

Front. Public Health

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“…PPIs inhibit gastric acid secretion and decrease the absorption of vitamin B12 [19]. Vitamin B12 is essential for blood cell production and causes macrocytic anemia in vitamin B12 deficiency [45,46]. Third, although the detailed mechanism of effects on the bone marrow is unknown, several reports have shown that cytopenia is induced by PPIs [47,48].…”

Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitors and Hyporesponsiveness to Erythropoiesis-Stimulating Agents in Hemodialysis Patients: Results from the Japan Dialysis Outcomes and Practice Patterns Study

Nakashima,

Miyawaki,

Komaba

et al. 2023

Am J Nephrol

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Introduction: Hyporesponsiveness to erythropoiesis stimulating agents (ESAs) is important problem in dialysis patients. While proton pump inhibitors (PPIs) may inhibit iron absorption, few studies have examined associations between PPIs and ESA-resistant anemia in hemodialysis patients. This study examined the associations between PPIs and ESA-resistant anemia in hemodialysis patients. Methods: The present study was a cross-sectional study using repeated 4-month observations, up to eight observations/patient, from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS). The primary outcome was erythropoietin resistance index (ERI). ESA dose, hemoglobin, proportion of erythropoietin-resistant anemia, transferrin saturation (TSAT), and ferritin were also examined. Linear or risk-difference regression models were used with generalized estimating equations to account for repeated measurements. Results: Of 1,644 patients, 867 patients had PPI prescriptions (52.7%). Patients prescribed PPI had higher ERI, higher ESA dose, and lower TSAT levels. Multivariable analysis for 12,048 four-month observations showed significantly greater ERI in PPI users (adjusted difference 0.95 IU/week/kg/[g/dL] [95% CI: 0.40–1.50]). Significant differences were also found in ESA dose (336 IU/week [95% CI: 70–602]) and the prevalence of erythropoietin-resistant anemia (3.9% [2.0–5.8%]) even after adjusted for TSAT and ferritin. Among possible mediators between the association of PPIs and anemia, TSAT was significantly different between PPI users and non-users (adjusted difference, −0.82% [95% CI: −1.56 to −0.07]). Conclusions: This study showed the associations between PPI and ERI, ESA dose, and TSAT in hemodialysis patients; physicians should consider anemia’s associations with PPIs in hemodialysis patients.

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“…Increased concentration of homocysteine in the blood is the most common laboratory marker commonly used to indicate this deficiency. These increased homocysteine levels have also been found to have a significant association with vascular deficits [59][60][61].…”

Section: Ppis and Reduced Nitric Oxide Bioavailability Via Vitamin B ...mentioning

confidence: 90%

Are Proton Pump Inhibitors Contributing in Emerging New Hypertensive Population?

Tayal,

Yasmin,

Chauhan

et al. 2023

Pharmaceuticals

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Balancing the therapeutic advantages of a medicine with its possible risks and side effects is an important part of medical practice and drug regulation. When a drug is designed to treat a particular disease or medical condition ends up causing additional risks or side effects that lead to the development of other serious health problems, it can have detrimental consequences for patients. This article explores the correlation between persistent proton pump inhibitor (PPI) use and hypertension, a common cardiovascular ailment. While PPIs are beneficial in treating various gastrointestinal problems, their availability without a prescription has resulted in self-medication and long-term use without medical monitoring. Recent findings have revealed a link between long-term PPI usage and increased cardiovascular risks, particularly hypertension. This study investigates the intricate mechanisms underlying PPI’s effects, focusing on potential pathways contributing to hypertension, such as endothelial dysfunction, disruption of nitric oxide bioavailability, vitamin B deficiency, hypocalcemia, and hypomagnesemia. The discussion explains how long-term PPI use can disrupt normal endothelial function, vascular control, and mineral balance, eventually leading to hypertension. The article emphasizes the significance of using PPIs with caution and ongoing research to better understand the implications of these medications on cardiovascular health.

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The Effects of Proton Pump Inhibitors in Acid Hypersecretion-Induced Vitamin B12 Deficiency: A Systematic Review (2022)

Cited by 7 publications

References 23 publications

Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study

Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study

Proton Pump Inhibitors and Hyporesponsiveness to Erythropoiesis-Stimulating Agents in Hemodialysis Patients: Results from the Japan Dialysis Outcomes and Practice Patterns Study

Are Proton Pump Inhibitors Contributing in Emerging New Hypertensive Population?

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