Open AccessDoes the use of proton pump inhibitors increase the risk of hypomagnesemia
Author(s) -
Susan Liao,
Li Gan,
Zhechuan Mei
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000015011
Subject(s) - hypomagnesemia , medicine , incidence (geometry) , relative risk , cochrane library , meta analysis , subgroup analysis , gastroenterology , medline , confidence interval , magnesium , materials science , metallurgy , physics , political science , law , optics
Background: Proton pump inhibitors (PPIs) are commonly used in the treatment of acid-related diseases; however, the association between the use of PPIs and potential risk of hypomagnesemia is controversial. Methods: In the present study, databases including PubMed, EMBASE, MEDLINE, PsycINFO, CINAHL, the Cochrane Library, and 4 Chinese databases were searched since the inception until April 2018. Previous observational studies on the incidence of hypomagnesemia in individuals exposed to PPIs were included. Results: This systematic review involved 15 studies including 129,347 participants, and the sample size varied from 52 to 95,205. Meta-analysis of 14 studies indicated that the use of PPIs increased the risk of hypomagnesemia [RR, 1.44, 95% CI, 1.13–1.76; I 2 , 85.2%]. Subgroup analysis revealed that the use of PPI was not associated with the incidence of hypomagnesemia in outpatients [RR, 1.49; 95% CI, 0.83–2.14; I 2 , 41.4%] and hospitalized patients [RR, 1.05; 95% CI, 0.81–1.29; I 2 , 62.1%], respectively. The use of PPIs was not related to the risk of hypomagnesemia based on the cut-off values of 1.8 mg/dL [RR, 1.73; 95% CI, 0.87–2.58; I 2 , 65.2%], 1.7 mg/dL [RR, 1.48; 95% CI, 0.90–2.06; I 2 , 87.6%], and 1.6 mg/dL [RR, 0.98; 95% CI, 0.69–1.27; I 2 , 67.9%]. Conclusion: The association between the exposure to PPI and the incidence of hypomagnesemia remained unclear. Due to the remarkable heterogeneity in previous studies, a definitive conclusion could not be drawn. Further research should be conducted to investigate the relationship between the use of individual PPI and potential risk of hypomagnesemia, and a dose-response analysis may be required.