Use of Proton Pump Inhibitors and Risk of Dementia or Alzheimer's Disease：a Meta-analysis

doi:10.12114/j.issn.1007-9572.2018.00.308

Abstract

Abstract: Background　Proton pump inhibitors （PPIs） are drugs that recognized for the treatment of most diseases related to abnormal gastric acid secretion，which are widely used among the elderly.Some prospective studies have indicated that PPI may increase the risk of dementia.However，the results of those studies were inconsistent and controversial.Therefore，it is necessary to determine whether PPI can increase the risk of dementia or Alzheimer's disease （AD） in elderly people.Objective　To evaluate the association between PPI and the risk of dementia or AD systematically.Methods　Prospective cohort studies and case-control studies that reported risk of dementia or AD causing by PPI were searched in PubMed，EMBase and Cochrane Library databases from their inception to February 2018.The Review Manager 5.3 software and STATA 12.0 software were used for Meta analysis.Results　A total of 9 studies were included，including 7 cohort studies and 2 case-control studies，with a total of 622 793 patients.Findings of Meta analysis showed that there was no statistically significant association between PPI use and risk of dementia〔RR=1.17，95%CI（0.89，1.55），P=0.26〕 or AD 〔RR=0.94，95%CI（0.89，1.00），P=0.06〕.Conclusion　Current research shows that there was no correlation between PPI use and the risk of dementia or AD，and using PPI will not increase the risk of having dementia or AD.

Key words: Dementia, Alzheimer disease, Proton pump inhibitors, Cohort studies, Case-control studies, Meta-analysis

摘要： 背景　质子泵抑制剂（PPI）是一种公认的用于治疗大多数与胃酸分泌异常有关疾病的药物，在老年人群中应用十分广泛。部分前瞻性研究指出服用PPI可能会增加老年人痴呆发生的风险。然而，这些研究的结果各异且存在争议性。故确定PPI能否引起老年人患痴呆或阿尔茨海默病（AD）风险增加十分必要。目的　系统评价PPI与痴呆或AD发病风险的相关性。方法　计算机检索PubMed、EMBase、Cochrane Library数据库有关PPI引起痴呆或AD发病风险的前瞻性队列研究及病例对照研究，检索时间从建库至2018年2月。使用Review Manager 5.3软件及STATA 12.0软件进行Meta分析。结果　共纳入9篇文献，其中队列研究7篇，病例对照研究2篇，共622 793例患者。Meta分析结果显示，PPI与痴呆发病风险无相关性〔相对危险度（RR）=1.17，95%CI（0.89，1.55），P=0.26〕；PPI与AD发病风险无相关性〔RR=0.94，95%CI（0.89，1.00），P=0.06〕。结论　目前研究表明，PPI与痴呆或AD发病风险无相关性，服用PPI不会增加痴呆或AD的发病风险。但研究结论不一致，还需要更多高质量文献进行支持。

关键词: 痴呆, 阿尔茨海默病, 质子泵抑制剂, 队列研究, 病例对照研究, Meta分析

YU Sisi,LUO Zheng,LI Miaomiao, et al. Use of Proton Pump Inhibitors and Risk of Dementia or Alzheimer's Disease：a Meta-analysis　[J]. Chinese General Practice, 2019, 22(23): 2861-2865. DOI: 10.12114/j.issn.1007-9572.2018.00.308.
喻思思,罗拯,李苗苗等. 质子泵抑制剂与痴呆或阿尔茨海默病发病风险相关性的Meta分析[J]. 中国全科医学, 2019, 22(23): 2861-2865. DOI: 10.12114/j.issn.1007-9572.2018.00.308.

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