Association Between Regular Use of Gastric Acid Suppressants and Subsequent Risk of Cholelithiasis: A Prospective Cohort Study of 0.47 Million Participants

Yang, Man; Xia, Bin; Lu, Ya‐Wen; He, Qiangsheng; Lin, Yanyan; Yue, Ping; Bai, Bing; Dong, Changfeng; Meng, Wenbo; Qi, Jian; Yuan, Jinqiu

doi:10.3389/fphar.2021.813587

Cited by 8 publications

(11 citation statements)

References 34 publications

(46 reference statements)

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“…However, a few reports suggest that proton pump inhibitors could increase gallstone disease risk. In a recent large prospective study using UK Biobank data, regular use of proton pump inhibitors and H2-receptor antagonists was associated with increased risk of gallstones 28. Associations of proton pump inhibitor use have also been reported with cholangitis,29 cholecystitis,30 and bile duct cancer 31,32.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent large prospective study using UK Biobank data, regular use of proton pump inhibitors and H2-receptor antagonists was associated with increased risk of gallstones. [28] Associations of proton pump inhibitor use have also been reported with cholangitis, [29] cholecystitis, [30] and bile duct cancer. [31,32] Possible mechanisms of gastric acid suppressants include decreased gallbladder motility leading to delayed gallbladder emptying, bile duct morphological changes, and gut microbiome imbalance and its effects on bile acid metabolism.…”

Section: Discussionmentioning

confidence: 99%

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Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US

Ruhl

2023

Hepatology

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Background and Aims: We examined gallbladder and biliary tract mortality predictors in the US National Health and Nutrition Examination Survey (NHANES), 1988-1994, with 31 years of linked mortality data, and gallstone disease prevalence trends and associations in NHANES 2017-March 2020 prepandemic data. Approach and Results: In NHANES 1988-1994, 18,794 participants were passively followed for mortality, identified by death certificate underlying or contributing causes, by linkage to the National Death Index through 2019. In NHANES 2017-March 2020, gallstone disease history was ascertained from 9232 adults. During NHANES 1988-2019 follow-up (median, 23.3 y), 8580 deaths occurred from all causes and 72 deaths with gallbladder or biliary tract disease. In multivariable-adjusted analysis, older age, male sex, prediabetes or diabetes, and physical inactivity were associated with gallbladder and biliary tract mortality, and non-Hispanic Black and Mexican American race-ethnicity were inversely associated. Between 1988-1994 and 2017-March 2020, gallstone disease prevalence increased from 7.4% to 13.9% and gallbladder surgery from 6.0% to 11.6%. In 2017-March 2020 in multivariable-adjusted analysis, female sex, diabetes, liver disease, proton pump inhibitors, abdominal pain, increased age, BMI, and liver stiffness were associated with gallstone disease, and non-Hispanic Black and non-Hispanic Asian race and alcohol were inversely associated. Conclusions: In the US population, gallstone disease prevalence doubled over 3 decades, possibly because of the worsening of metabolic risk factors and growth of laparoscopic cholecystectomy. Gallbladder and biliary tract mortality and gallstone disease associations included factors such as prediabetes or diabetes, liver stiffness and proton pump inhibitors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US

Ruhl

2023

Hepatology

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“…At baseline, regular use of PPI was first recorded using an electronic questionnaire and then confirmed by a United Kingdom Biobank nurse ( Yang et al, 2021 ; Yang et al, 2021 ; Xia et al, 2021 ). The recorded type of PPIs included omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole.…”

Section: Methodsmentioning

confidence: 99%

Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank

Zhang

Jing

et al. 2022

Front. Pharmacol.

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Background: Proton pump inhibitors (PPIs) are widely used and have been linked to kidney diseases. However, the role of PPI use in the development of chronic kidney disease (CKD) remains unclear. We undertook this study to examine the association between PPI use and the subsequent risk of CKD.Methods: This is a prospective analysis of 462,421 participants free of cancer diagnosis or chronic kidney disease from the United Kingdom Biobank. Self-reported PPI use was recorded using an electronic questionnaire and confirmed by a trained staff. Incident CKD was identified based on the medical history. Overlap propensity score weighting with the Cox model was used to calculate the effect of PPI use on CKD risk. The number needed to harm (NNH) was calculated at 5 and 10 years of follow-up.Results: We documented 7,031 cases of CKD over a median follow-up of 8.1 years. Overlap propensity score weighting analysis showed that regular PPI users had a 37% higher risk of CKD incident than non-users (HR 1.37, 95% CI 1.28–1.47). The association persisted across subgroup analyses, different types of PPIs, and several sensitivity analyses. Quantitative bias analysis indicated that the result was robust to unmeasured confounding (E-value 2.08, lower 95% CI 1.88). The NNH was 147.9 and 78.6 for 5 and 10 years of follow-up, respectively. A head-to-head comparison showed that PPI users had a 19% higher risk of CKD than H2RA users (HR 1.19, 95% CI 1.02–1.39).Conclusion: The regular use of PPI is associated with a higher risk of CKD. Healthcare providers should carefully weigh up the potential benefits against the risk in prescribing PPIs, particularly for patients requiring long-term treatment.

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“…The two are connected through the duodenum and blood, and colonizing the biliary tract is not difficult for intestinal bacteria. Another recent prospective cohort study based on 470,000 participants demonstrated an association between an increased risk of gallstones and disturbances in the gut microbiota caused by the use of stomach acid inhibitors ( 86 ). A team found that the intestinal microbiota of mice with gallstones is seriously disordered and identified 33 gallstone markers at the phylum, class, order, family, and genus levels.…”

Section: Gut Microbiota and Gallbladder Principal Diseasesmentioning

confidence: 99%

The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases

Huang

Yang²,

Li³

et al. 2023

Front. Nutr.

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The gut microbiota is a complex ecosystem that has coevolved with the human body for hundreds of millions of years. In the past 30 years, with the progress of gene sequencing and omics technology, the research related to gut microbiota has developed rapidly especially in the field of digestive system diseases and systemic metabolic diseases. Mechanical, biological, immune, and other factors make the intestinal flora form a close bidirectional connection with the liver and gallbladder, which can be called the “gut–liver–biliary axis.” Liver and gallbladder, as internal organs of the peritoneum, suffer from insidious onset, which are not easy to detect. The diagnosis is often made through laboratory chemical tests and imaging methods, and intervention measures are usually taken only when organic lesions have occurred. At this time, some people may have entered the irreversible stage of disease development. We reviewed the literature describing the role of intestinal flora in the pathogenesis and biotherapy of hepatobiliary diseases in the past 3–5 years, including the dynamic changes of intestinal flora at different stages of the disease, as well as the signaling pathways involved in intestinal flora and its metabolites, etc. After summarizing the above contents, we hope to highlight the potential of intestinal flora as a new clinical target for early prevention, early diagnosis, timely treatment and prognosis of hepatobiliary diseases.

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Association Between Regular Use of Gastric Acid Suppressants and Subsequent Risk of Cholelithiasis: A Prospective Cohort Study of 0.47 Million Participants

Cited by 8 publications

References 34 publications

Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US

Increasing gallstone disease prevalence and associations with gallbladder and biliary tract mortality in the US

Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank

The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases

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