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The association between the use of proton pump inhibitors and the risk of hypomagnesemia: a systematic review and meta-analysis.

Authors
 Chan Hyuk Park  ;  Eun Hye Kim  ;  Yun Ho Roh  ;  Ha Yan Kim  ;  Sang Kil Lee 
Citation
 PLoS One, Vol.9(11) : e112558, 2014 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2014
Abstract
BACKGROUND: Although many case reports have described patients with proton pump inhibitor (PPI)-induced hypomagnesemia, the impact of PPI use on hypomagnesemia has not been fully clarified through comparative studies. We aimed to evaluate the association between the use of PPI and the risk of developing hypomagnesemia by conducting a systematic review with meta-analysis. METHODS: We conducted a systematic search of MEDLINE, EMBASE, and the Cochrane Library using the primary keywords "proton pump," "dexlansoprazole," "esomeprazole," "ilaprazole," "lansoprazole," "omeprazole," "pantoprazole," "rabeprazole," "hypomagnesemia," "hypomagnesaemia," and "magnesium." Studies were included if they evaluated the association between PPI use and hypomagnesemia and reported relative risks or odds ratios or provided data for their estimation. Pooled odds ratios with 95% confidence intervals were calculated using the random effects model. Statistical heterogeneity was assessed with Cochran's Q test and I2 statistics. RESULTS: Nine studies including 115,455 patients were analyzed. The median Newcastle-Ottawa quality score for the included studies was seven (range, 6-9). Among patients taking PPIs, the median proportion of patients with hypomagnesemia was 27.1% (range, 11.3-55.2%) across all included studies. Among patients not taking PPIs, the median proportion of patients with hypomagnesemia was 18.4% (range, 4.3-52.7%). On meta-analysis, pooled odds ratio for PPI use was found to be 1.775 (95% confidence interval 1.077-2.924). Significant heterogeneity was identified using Cochran's Q test (df = 7, P<0.001, I2 = 98.0%). CONCLUSIONS: PPI use may increase the risk of hypomagnesemia. However, significant heterogeneity among the included studies prevented us from reaching a definitive conclusion.
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DOI
10.1371/journal.pone.0112558
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김은혜(Kim, Eun Hye) ORCID logo https://orcid.org/0000-0001-6691-6837
김하얀(Kim, Ha Yan)
노윤호(Roh, Yun Ho)
박찬혁(Park, Chan Hyuk)
이상길(Lee, Sang Kil) ORCID logo https://orcid.org/0000-0002-0721-0364
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138687
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