Proton Pump Inhibitors, Nephropathy, and Cardiovascular Disease in Type 2 Diabetes: The Fremantle Diabetes Study

Davis, Timothy; Drinkwater, Jocelyn J.; Davis, Wendy A.

doi:10.1210/jc.2017-00354

Cited by 18 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, those studies did not take into account the severity of diabetes, such as HbA1c, duration of diabetes, and oral drugs/insulin use. To our best knowledge, there is only one prospective study that investigated the association of PPIs use and CVD risk among 1732 patients with T2D with an average of 2.1 years of follow-up [29]. In line with the previous study, our study also showed PPIs use was associated with higher risk of CVD, as well as all-cause mortality.…”

Section: Discussionsupporting

confidence: 89%

“…Patients with T2D are at more than three times higher prevalence of using PPIs [27], and two-to fourfold higher risk of developing cardiovascular complications and premature death than general populations [28]; however, the evidence regarding the in uence of PPIs use on subsequent risks of CVD and mortality among patients with T2D is scarce. To our best knowledge, only one prospective study from Australia showed PPI initiation was associated with a higher risk of 5-year CVD risk among patients with T2D [29]. However, the previous study had a sample size of 1732, a mean follow-up period of 2.1 years, and only a composite CVD outcome; further studies with larger sample size, longer follow-up period, and a closer investigation of CVD subtypes are needed.…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Proton Pump Inhibitors Use and Risks of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes: A Prospective Study in the UK Biobank

Geng

Chen

Zhou

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Proton pump inhibitors (PPIs) are widely used drugs for gastric-acid-related diseases, which may have an impact on the gut microbiome. We aimed to evaluate the associations of PPIs use with risks of cardiovascular disease (CVD) and all-cause mortality in patients with type 2 diabetes (T2D).Methods: We analysed the associations of PPIs use with risks of coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality in 19,229 adults with T2D using data from the UK Biobank study.Results: During a median follow-up of 10.9-11.2 years, we documented a total of 2,971 CAD, 1,827 MI, 1,192 HF, and 738 stroke cases, along with 2,297 total deaths. PPIs use was significantly associated with higher risks of CAD (HR, 1.27; 95% CI, 1.15-1.40), MI (HR, 1.34; 95% CI, 1.18-1.52), HF (HR, 1.35; 95% CI, 1.16-1.57) and all-cause mortality (HR, 1.30; 95% CI, 1.16-1.45). No significant association was observed between PPIs use and stroke (HR, 1.11; 95% CI, 0.90-1.36). The results were consistent in the subgroup analyses stratified by factors including indications of PPIs, anti-diabetic medication use, and antiplatelet drug use. Analyses in a 1:1 propensity score-matched cohort of PPIs users versus non-users yielded consistent results. Conclusion: Our data suggested that PPIs use was associated with higher risks of CVD events and mortality among patients with T2D. Prescription of PPIs among patients with T2D should be cautious, and monitoring of adverse cardiovascular events during PPIs therapy should be enhanced.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 97%

Proton Pump Inhibitors Use and Risks of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes: A Prospective Study in the UK Biobank

Geng

Chen

Zhou

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The inhibition of the efficacy of clopidogrel could increase the risk of thromboembolism and coronary syndrome [25]. Because of impaired vasodilation and ischemic changes associated with PPIs, a number of previous studies have demonstrated an increased risk of cardiovascular diseases related to PPI use [26,27]. A review study described that PPI use was related to excess mortality from cardiovascular diseases in 15/1000 persons [27].…”

Section: Discussionmentioning

confidence: 99%

Association between Proton Pump Inhibitors and Hearing Impairment: A Nested Case-Control Study

Kim

Lee

Min

et al. 2021

CIMB

View full text Add to dashboard Cite

This study investigated the association of previous use of proton pump inhibitors (PPIs) with the rate of hearing impairment. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort was enrolled. The 6626 registered hearing-impaired patients were matched with 508,240 control participants for age, sex, income, region of residence, and index date (date of hearing impairment diagnosis). The prescription histories of PPIs were collected for 2 years before the index date. The odds ratios of the duration of PPI use for hearing impairment were analyzed using conditional logistic regression. Subgroups of age/sex and severity of hearing impairments were additionally analyzed for the relation of PPI use with hearing impairment. PPI use for 30–365 days was associated with a 1.65-times higher odds of hearing impairment (95% confidence interval (CI) = 1.47–1.86 for 30–365 days of PPI medication). PPI use for ≥365 days was also related to 1.52-times higher odds of hearing impairment (95% CI = 1.35–1.72, p < 0.001). All age and sex subgroups demonstrated a positive association between PPI use and hearing impairment. Severe hearing impairment showed consistently higher odds of a relation with PPI use. PPI use was associated with an increased rate of hearing impairment.

show abstract

“…These include the use of vitamin B12 supplementation and proton pump inhibitor (PPI) therapy. The use of PPIs is common in type 2 diabetes, 17 and they have the potential to interact with metformin to increase the risk of B12 deficiency by further reducing absorption 18 . In addition, almost all studies published to date have assessed deficiency from total vitamin B12 concentrations rather than measurement of the transcobalamin–vitamin B12 complex (holotranscobalamin), which represents the biologically active form taken up through specific cell surface receptors 19 .…”

Section: Introductionmentioning

confidence: 99%

Serum vitamin B12, distal symmetrical polyneuropathy and anaemia in type 2 diabetes: the Fremantle Diabetes Study Phase 2

Davis,

Chubb,

Peters

et al. 2023

Internal Medicine Journal

View full text Add to dashboard Cite

BackgroundThere are limited data relating to the effects of metformin‐associated vitamin B12 deficiency on the risk of distal symmetrical polyneuropathy (DSPN) and megaloblastic anaemia in well‐characterised community‐based cohorts.AimsTo assess inter‐relationships between metformin therapy, vitamin B12 deficiency assessed using serum active B12 concentrations, and DSPN and anaemia in 1492 Fremantle Diabetes Study Phase 2 (FDS2) participants with type 2 diabetes.MethodsPrevalence rates of vitamin B12 deficiency (total <80 pmol/L, active <23 pmol/L) and borderline deficiency (total ≥80 and ≤200 pmol/L, active ≥23 and ≤35 pmol/L) were determined using baseline sera. The relationship between vitamin B12 status and both DSPN and anaemia was assessed using multivariable analyses.ResultsMost FDS2 participants (94.4%) were vitamin B12 replete (total serum concentration >200 pmol/L, active >35 pmol/L), 2.0% were deficient (total <80 pmol/L, active <23 pmol/L) and the remainder (3.6%) borderline. Although metformin treatment increased the odds of deficiency (4.2%, 3.1% borderline) in a dose‐dependent fashion (odds ratio (95% confidence interval) 39.4 (4.90–316) for >2000 mg daily compared with no treatment; P < 0.001), there was no significant association between vitamin B12 status and DSPN, anaemia (haemoglobin ≤130 g/L males, ≤120 g/L females), haemoglobin concentration or mean corpuscular volume (P ≥ 0.147). Metformin increased the likelihood of anaemia, especially at high doses, independent of vitamin B12 deficiency.ConclusionsSince nutritional sources likely attenuate metformin‐associated vitamin B12 malabsorption and its clinical sequelae in developed countries such as Australia, there is no need for routine/opportunistic serum vitamin B12 screening in metformin‐treated patients.

show abstract

Proton Pump Inhibitors, Nephropathy, and Cardiovascular Disease in Type 2 Diabetes: The Fremantle Diabetes Study

Abstract: Although PPI use was not associated with a sustained adverse effect on uACR, the association between PPI initiation and both worsening nephropathy and increasing 5-year CVD risk has potential clinical implications in type 2 diabetes.

Cited by 18 publications

References 23 publications

Proton Pump Inhibitors Use and Risks of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes: A Prospective Study in the UK Biobank

Proton Pump Inhibitors Use and Risks of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes: A Prospective Study in the UK Biobank

Association between Proton Pump Inhibitors and Hearing Impairment: A Nested Case-Control Study

Serum vitamin B12, distal symmetrical polyneuropathy and anaemia in type 2 diabetes: the Fremantle Diabetes Study Phase 2

Contact Info

Product

Resources

About