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Female gender, dosage predict gastrin elevation in GERD patients on long-term PPI therapy

13 Feb 2020

Dosage and female gender are associated with the development of gastrin elevation following proton pump inhibitor (PPI) therapy, a recent study has found. Moreover, fasting serum gastrin significantly correlates with PPI dosage over weight and over body surface area.

This cross-sectional study sought to determine the most important predictors for gastrin elevation in patients on long-term PPI therapy through analysis of data from two published studies in Icelandic patients with endoscopically verified erosive gastro-oesophageal reflux disease (GERD).

The investigators compared PPI exposure in dosage over weight (mg/kg) and dosage over body surface area (mg/m2) with fasting gastrin levels in two separate multiple linear regression models. They also obtained data on age, gender, weight, smoking, H. pylori infection, and PPI duration and type.

Analysis was conducted in 157 patients (78 females). Females had significantly higher median serum gastrin levels than males (92 vs 60 pg/mL; p=0.001). In simple linear regression, serum gastrin levels was associated with gender (p=0.0008) and PPI exposure in mg/kg (p=0.0001) and mg/m2 (p=0.0001).

In multiple linear regression, higher gastrin values were predicted by PPI exposure, both in mg/kg (β, 0.95, 95 percent confidence interval [CI], 0.4–1.5; p=0.001) and mg/m2 (β, 0.02, 95 percent CI, 0.0–0.0; p=0.0015) and female gender (β, 0.2, 95 percent CI, 0.0–0.4; p=0.02).

“Gastrin elevation is a known but variable consequence of PPI therapy,” the investigators noted. “Concerns have been raised about the clinical importance of chronic PPI induced gastrin elevation.”

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Most Read Articles
27 Nov 2017
The amino sulphonic acid taurine may safely and effectively reduce portal pressure in cirrhotic patients, a study has shown.
Prof. Vincent Wong, Prof. Ray Kim, Dr. Tan Poh Seng, 10 Sep 2019
Chronic hepatitis B (CHB) remains a major public health concern because of its worldwide distribution and potential adverse sequelae, including cirrhosis and hepatocellular carcinoma (HCC). At a recent symposium held during the GIHep Singapore 2019, Professor Vincent Wong from the Chinese University of Hong Kong and Professor Ray Kim from the Stanford University School of Medicine, Stanford, California, US, discussed antiviral treatments for CHB, with a focus on the novel agent tenofovir alafenamide (Vemlidy®). Dr Tan Poh Seng from the National University Hospital, Singapore, chaired the symposium.
26 Nov 2019
Podcast: Professor R. Scott Wright speaks about the potential role of inclisiran in providing durable reductions in LDL-cholesterol levels in patients with atherosclerotic cardiovascular disease.
Jairia Dela Cruz, 12 Dec 2019
Use of isatuximab (Isa) in combination with pomalidomide and dexamethasone (PomDex) appears to lead to more favourable outcomes in elderly patients with relapsed/refractory multiple myeloma (RRMM) as compared with PomDex alone, according to the results of a subgroup analysis of the ICARIA-MM trial presented at the 61st Annual Meeting of the American Society of Hematology (ASH 2019).