Season of birth: A potential influential factor for quality of life
Yang et al. have reported a significantly higher incidence of hip fracture in patients on PPI, and such incidence increases with therapy duration and with PPI dose [9]. Regarding these data, we hypothesized that long-term therapy with PPI is associated with decreased bone density, and consequently with increased incidence of its clinical manifestations: osteoporosis, fractures, and hip fractures. We also hypothesized that mechanism of action of these drugs is not through their effect on vacuolar ATPase in osteoclasts, but rather through decrease in calcium absorption in the small intestine. As a result, there is less calcium in the human organism available for mineralisation of bone tissue and consequently, bone density decreases. However, we recognize that further studies are necessary to measure exact bone density change by DXA absorptiometry or ultrasound in patients on long-term PPI therapy. Supplementary research is also needed in order to identify the exact mechanism of action of these drugs on bone density change.