Predictors of Gastrin Elevation Following Proton Pump Inhibitor Therapy.

• Published in: Journal of Clinical Gastroenterology
• Main Authors: Helgadóttir, Hólmfridur, Lund, Sigrún H, Gizurarson, Sveinbjörn, Metz, David C, Björnsson, Einar S
• Other Authors: 1Department of Internal Medicine, Division of Gastroenterology, Landspitali-The National University Hospital of Iceland. 2Faculty of Medicine. 3Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavík, Iceland. 4Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wolters Kluwer Health 2020
• Subjects: Prótónupumpuhemlar; Meltingarfærasjúkdómar; Proton Pump Inhibitors; Gastrins; Gerd; Iceland
• Online Access: http://hdl.handle.net/2336/621341; https://doi.org/10.1097/MCG.0000000000001200

To access publisher's full text version of this article click on the hyperlink below Goals: The goal of this study was to elucidate the most important predictors for elevation of gastrin in patients on long-term PPI therapy through analysis of data from 2 published studies in Icelandic patients with erosive GERD. Background: Gastrin elevation is a known but variable consequence of proton pump inhibitor (PPI) therapy. Concerns have been raised about the clinical importance of chronic PPI induced gastrin elevation. Study: This cross-sectional analysis included patients with endoscopically verified erosive esophagitis receiving long-term PPI therapy. PPI exposure in dosage over weight (mg/kg) and dosage over body surface area (mg/m) was compared with fasting gastrin levels in two separate multiple linear regression models. Data was collected on age, gender, weight, H. pylori infection, smoking, PPI duration and type. Results: Overall data from 157 patients (78 females) were analyzed. Median serum gastrin levels were higher in females than males (92 vs. 60 pg/mL; P=0.001). Simple linear regression showed a correlation between serum gastrin levels and gender (P=0.0008) as well as PPI exposure in mg/kg (P=0.0001) and mg/m (P=0.0001). Multiple linear regression analysis showed that PPI exposure, both in mg/kg (β=0.95 [CI=0.4-1.5]; P=0.001) and mg/m (β=0.02 [CI=0.0-0.0]; P=0.0015) along with female gender (β=0.2 [CI=0.0-0.4]; P=0.02) predicted higher gastrin values. Conclusions: Dosage and female gender seem to play an important role in the development of gastrin elevation on PPI therapy. A significant correlation was found between fasting serum gastrin and dosage of PPIs over weight and body surface area. Research Fund of the National University Hospital of Iceland University of Iceland Research Fund United States Department of Health & Human Services National Institutes of Health (NIH) - USA Icelandic Research Fund