caa a22 4500 44579626X CHVBK 20180317145126.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1589-y doi (NATIONALLICENCE)springer-10.1007/s10620-011-1589-y Association Between Proton Pump Inhibitor Use and Anemia: A Retrospective Cohort Study [Elektronische Daten] [Erin Sarzynski, Chethan Puttarajappa, Yan Xie, Madhusudan Grover, Heather Laird-Fick] Background: Proton pump inhibitors (PPIs) are widely prescribed to treat gastrointestinal diseases. However, concerns have been raised regarding their long-term use. Gastric acid suppression may decrease iron absorption, and it remains uncertain whether iron-deficiency anemia may result from chronic PPI therapy. Aims: We aimed to explore the association between chronic PPI use and iron-deficiency anemia. Methods: We conducted a retrospective cohort study of adult patients in an academic outpatient setting who received PPI therapy for at least 1year between January 1, 2004 and January 1, 2006. We compared the change in hematologic indices among patients receiving PPI therapy for at least 1year with matched controls. Results: Of the 98 patients on chronic PPI therapy who met inclusion criteria, 35% had no documented indication for such therapy. At baseline, demographics and hematologic indices were similar between PPI-users and controls. Among patients on PPI therapy, all hematologic indices decreased from baseline, including hemoglobin (−0.19g/dL, P=0.03), hematocrit (−0.63%, P=0.02), and mean corpuscular volume (−0.49 fL, P=0.05). PPI users had significant decreases in mean hemoglobin and hematocrit (P<0.01 for both) compared with matched controls. After adjustment for confounders, including rates of esophagogastroduodenoscopy, colonoscopy and remote cancer status, the odds ratio of decreasing hemoglobin by 1.0g/dL while on chronic PPI therapy was 5.03 (95% CI, 1.71-14.78, P<0.01), while the odds ratio of decreasing hematocrit by 3% was 5.46 (95% CI, 1.67-17.85, P<0.01). Conclusions: Among adult patients receiving chronic PPI therapy, there is a significant decrease in hematologic indices from baseline. Springer Science+Business Media, LLC, 2011 Proton pump inhibitor nationallicence Anemia nationallicence Malabsorption nationallicence Iron deficiency nationallicence Sarzynski Erin Department of Medicine, Michigan State University, B-301 Clinical Center, 48824, East Lansing, MI, USA aut Puttarajappa Chethan Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, A919 Scaife Hall, 3550 Terrace Street, 15261, Pittsburgh, PA, USA aut Xie Yan Center for Statistical Training and Consulting, Michigan State University, 178 Giltner Hall, 48824, East Lansing, MI, USA aut Grover Madhusudan Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Laird-Fick Heather Department of Medicine, Michigan State University, B-301 Clinical Center, 48824, East Lansing, MI, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2349-2353 0163-2116 56:8<2349 2011 56 10620 https://doi.org/10.1007/s10620-011-1589-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1589-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sarzynski Erin Department of Medicine, Michigan State University, B-301 Clinical Center, 48824, East Lansing, MI, USA aut NATIONALLICENCE 700 1- Puttarajappa Chethan Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, A919 Scaife Hall, 3550 Terrace Street, 15261, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Xie Yan Center for Statistical Training and Consulting, Michigan State University, 178 Giltner Hall, 48824, East Lansing, MI, USA aut NATIONALLICENCE 700 1- Grover Madhusudan Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Laird-Fick Heather Department of Medicine, Michigan State University, B-301 Clinical Center, 48824, East Lansing, MI, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2349-2353 0163-2116 56:8<2349 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer