Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies
ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 dia...
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| Veröffentlicht in: | Gut 2021-06, Vol.70 (6), p.1070-1077 |
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| creator | Yuan, Jinqiu He, Qiangsheng Nguyen, Long H Wong, Martin C S Huang, Junjie Yu, Yuanyuan Xia, Bin Tang, Yan He, Yulong Zhang, Changhua |
| description | ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use. |
| doi_str_mv | 10.1136/gutjnl-2020-322557 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2447313109</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2523035415</sourcerecordid><originalsourceid>FETCH-LOGICAL-b474t-9648abd5e884af1d13d695cd2b61ac16ccd9a6c8c03122828d9e796f9d86ddec3</originalsourceid><addsrcrecordid>eNqNkU1rFTEYhYMo9lr9Ay4k4KabqfmaTOJOirVCQSh1HTLJO725zkzGfAj9985laoUuxFV44TmHEx6E3lJyTimXH-5qOcxjwwgjDWesbbtnaEeFVOul1HO0I4R2TdsJfYJe5XwghCil6Ut0wplWmjC6Q8sN3NXRJlwz4DjgJcUSZ7zUacFh3oc-lJgytrPHKeQfR6TcL4AZ9sH2UCB_xAlyHUvGQ4oTLvsEcKzJC7gSfgF2cR9TwblUHyC_Ri8GO2Z48_Ceou-Xn28vrprrb1--Xny6bnrRidJoKZTtfQtKCTtQT7mXunWe9ZJaR6VzXlvplCOcMqaY8ho6LQftlfQeHD9FZ1vvOuVnhVzMFLKDcbQzxJoNE6LjlFOiV_T9E_QQa5rXdYa1jBPeCtquFNsot_4tJxjMksJk072hxBx9mM2HOfowm4819O6huvYT-MfIHwEr0GxAPx3-r_D8L_848x-B39mupgs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2523035415</pqid></control><display><type>article</type><title>Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies</title><source>MEDLINE</source><source>PubMed Central</source><creator>Yuan, Jinqiu ; He, Qiangsheng ; Nguyen, Long H ; Wong, Martin C S ; Huang, Junjie ; Yu, Yuanyuan ; Xia, Bin ; Tang, Yan ; He, Yulong ; Zhang, Changhua</creator><creatorcontrib>Yuan, Jinqiu ; He, Qiangsheng ; Nguyen, Long H ; Wong, Martin C S ; Huang, Junjie ; Yu, Yuanyuan ; Xia, Bin ; Tang, Yan ; He, Yulong ; Zhang, Changhua</creatorcontrib><description>ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2020-322557</identifier><identifier>PMID: 32989021</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Acid inhibitory therapy ; Adult ; Aged ; Aged, 80 and over ; Antibiotics ; Clinical medicine ; Cohort analysis ; Diabetes ; diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - epidemiology ; Disease ; epidemiology ; Family medical history ; Female ; Follow-Up Studies ; Glucose ; Health Surveys ; Histamine H2 Antagonists - therapeutic use ; Humans ; Incidence ; Male ; Medical personnel ; Metabolism ; Microbiota ; Middle Aged ; Nurses ; Prospective Studies ; proton pump inhibition ; Proton pump inhibitors ; Proton Pump Inhibitors - therapeutic use ; Public health ; Questionnaires ; Risk Factors ; Time Factors ; Ulcers ; United States - epidemiology ; Vitamins</subject><ispartof>Gut, 2021-06, Vol.70 (6), p.1070-1077</ispartof><rights>Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2021 Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b474t-9648abd5e884af1d13d695cd2b61ac16ccd9a6c8c03122828d9e796f9d86ddec3</citedby><cites>FETCH-LOGICAL-b474t-9648abd5e884af1d13d695cd2b61ac16ccd9a6c8c03122828d9e796f9d86ddec3</cites><orcidid>0000-0001-7030-9853 ; 0000-0002-1902-0963 ; 0000-0001-6124-8091 ; 0000-0001-7706-9370 ; 0000-0002-5436-4219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32989021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yuan, Jinqiu</creatorcontrib><creatorcontrib>He, Qiangsheng</creatorcontrib><creatorcontrib>Nguyen, Long H</creatorcontrib><creatorcontrib>Wong, Martin C S</creatorcontrib><creatorcontrib>Huang, Junjie</creatorcontrib><creatorcontrib>Yu, Yuanyuan</creatorcontrib><creatorcontrib>Xia, Bin</creatorcontrib><creatorcontrib>Tang, Yan</creatorcontrib><creatorcontrib>He, Yulong</creatorcontrib><creatorcontrib>Zhang, Changhua</creatorcontrib><title>Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies</title><title>Gut</title><addtitle>Gut</addtitle><addtitle>Gut</addtitle><description>ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.</description><subject>Acid inhibitory therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibiotics</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Diabetes</subject><subject>diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Disease</subject><subject>epidemiology</subject><subject>Family medical history</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucose</subject><subject>Health Surveys</subject><subject>Histamine H2 Antagonists - therapeutic use</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Metabolism</subject><subject>Microbiota</subject><subject>Middle Aged</subject><subject>Nurses</subject><subject>Prospective Studies</subject><subject>proton pump inhibition</subject><subject>Proton pump inhibitors</subject><subject>Proton Pump Inhibitors - therapeutic use</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Ulcers</subject><subject>United States - epidemiology</subject><subject>Vitamins</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkU1rFTEYhYMo9lr9Ay4k4KabqfmaTOJOirVCQSh1HTLJO725zkzGfAj9985laoUuxFV44TmHEx6E3lJyTimXH-5qOcxjwwgjDWesbbtnaEeFVOul1HO0I4R2TdsJfYJe5XwghCil6Ut0wplWmjC6Q8sN3NXRJlwz4DjgJcUSZ7zUacFh3oc-lJgytrPHKeQfR6TcL4AZ9sH2UCB_xAlyHUvGQ4oTLvsEcKzJC7gSfgF2cR9TwblUHyC_Ri8GO2Z48_Ceou-Xn28vrprrb1--Xny6bnrRidJoKZTtfQtKCTtQT7mXunWe9ZJaR6VzXlvplCOcMqaY8ho6LQftlfQeHD9FZ1vvOuVnhVzMFLKDcbQzxJoNE6LjlFOiV_T9E_QQa5rXdYa1jBPeCtquFNsot_4tJxjMksJk072hxBx9mM2HOfowm4819O6huvYT-MfIHwEr0GxAPx3-r_D8L_848x-B39mupgs</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Yuan, Jinqiu</creator><creator>He, Qiangsheng</creator><creator>Nguyen, Long H</creator><creator>Wong, Martin C S</creator><creator>Huang, Junjie</creator><creator>Yu, Yuanyuan</creator><creator>Xia, Bin</creator><creator>Tang, Yan</creator><creator>He, Yulong</creator><creator>Zhang, Changhua</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7030-9853</orcidid><orcidid>https://orcid.org/0000-0002-1902-0963</orcidid><orcidid>https://orcid.org/0000-0001-6124-8091</orcidid><orcidid>https://orcid.org/0000-0001-7706-9370</orcidid><orcidid>https://orcid.org/0000-0002-5436-4219</orcidid></search><sort><creationdate>20210601</creationdate><title>Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies</title><author>Yuan, Jinqiu ; He, Qiangsheng ; Nguyen, Long H ; Wong, Martin C S ; Huang, Junjie ; Yu, Yuanyuan ; Xia, Bin ; Tang, Yan ; He, Yulong ; Zhang, Changhua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b474t-9648abd5e884af1d13d695cd2b61ac16ccd9a6c8c03122828d9e796f9d86ddec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acid inhibitory therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibiotics</topic><topic>Clinical medicine</topic><topic>Cohort analysis</topic><topic>Diabetes</topic><topic>diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Disease</topic><topic>epidemiology</topic><topic>Family medical history</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glucose</topic><topic>Health Surveys</topic><topic>Histamine H2 Antagonists - therapeutic use</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Metabolism</topic><topic>Microbiota</topic><topic>Middle Aged</topic><topic>Nurses</topic><topic>Prospective Studies</topic><topic>proton pump inhibition</topic><topic>Proton pump inhibitors</topic><topic>Proton Pump Inhibitors - therapeutic use</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Ulcers</topic><topic>United States - epidemiology</topic><topic>Vitamins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yuan, Jinqiu</creatorcontrib><creatorcontrib>He, Qiangsheng</creatorcontrib><creatorcontrib>Nguyen, Long H</creatorcontrib><creatorcontrib>Wong, Martin C S</creatorcontrib><creatorcontrib>Huang, Junjie</creatorcontrib><creatorcontrib>Yu, Yuanyuan</creatorcontrib><creatorcontrib>Xia, Bin</creatorcontrib><creatorcontrib>Tang, Yan</creatorcontrib><creatorcontrib>He, Yulong</creatorcontrib><creatorcontrib>Zhang, Changhua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yuan, Jinqiu</au><au>He, Qiangsheng</au><au>Nguyen, Long H</au><au>Wong, Martin C S</au><au>Huang, Junjie</au><au>Yu, Yuanyuan</au><au>Xia, Bin</au><au>Tang, Yan</au><au>He, Yulong</au><au>Zhang, Changhua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><addtitle>Gut</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>70</volume><issue>6</issue><spage>1070</spage><epage>1077</epage><pages>1070-1077</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>32989021</pmid><doi>10.1136/gutjnl-2020-322557</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7030-9853</orcidid><orcidid>https://orcid.org/0000-0002-1902-0963</orcidid><orcidid>https://orcid.org/0000-0001-6124-8091</orcidid><orcidid>https://orcid.org/0000-0001-7706-9370</orcidid><orcidid>https://orcid.org/0000-0002-5436-4219</orcidid></addata></record> |
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| subjects | Acid inhibitory therapy Adult Aged Aged, 80 and over Antibiotics Clinical medicine Cohort analysis Diabetes diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - epidemiology Disease epidemiology Family medical history Female Follow-Up Studies Glucose Health Surveys Histamine H2 Antagonists - therapeutic use Humans Incidence Male Medical personnel Metabolism Microbiota Middle Aged Nurses Prospective Studies proton pump inhibition Proton pump inhibitors Proton Pump Inhibitors - therapeutic use Public health Questionnaires Risk Factors Time Factors Ulcers United States - epidemiology Vitamins |
| title | Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies |
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