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The effect of long-term proton pump inhibitor use on the visceral adiposity index

Year 2025, Volume: 38 Issue: 3, 227 - 231, 10.10.2025
https://doi.org/10.5472/marumj.1800011

Abstract

Objective: To investigate whether long-term proton pump inhibitor (PPI) use (≥3 years) is associated with changes in visceral adiposity
index (VAI) and lipid profile
Patients and Methods: Between September 2020 and May 2022, 51 long-term PPI users (PG) and 75 age – and sex-matched controls
(CG) were enrolled. Demographics, waist circumference (WC), body mass index (BMI), triglycerides (TG), low-density lipoprotein
cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and VAI (calculated via validated sex-specific formulas) were
recorded. Statistical analysis was performed using SPSS 23.0 with independent t-test/Mann–tests and logistic regression.
Results: The PG exhibited significantly higher WC (97.1 ± 19.8 vs. 90.1 ± 16.7 cm; p=0.036), TG (148.8 ± 58.3 vs. 125.8 ± 48.6 mg/dL;
p=0.018), and VAI (2.74 ± 1.59 vs. 2.12 ± 1.47; p=0.028) compared to controls. HDL-C and LDL-C differences were not significant.
Male sex approached borderline significance as a predictor of elevated VAI in regression analysis.
Conclusion: Long-term PPI use is associated with increased WC, TG, and VAI despite no significant changes in HDL-C or LDL-C,
suggesting a potential metabolic risk. Clinicians should consider this when prescribing PPIs; prospective large population based
studies are warranted.

References

  • Forgacs I, Loganayagam A. Overprescribing proton pump inhibitors. BMJ 2008;336:2-3. doi: 10.1136/bmj.39406.449456. BE.
  • Scarpignato C, Gatta L, Zullo A, et al. Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression. BMC Med 2016;14:179. doi: 10.1186/ s12916.016.0718-z.
  • Metz DC. Long-term use of proton-pump inhibitor therapy. Gastroenterol Hepatol (N Y) 2008;4:322-5.
  • Lundell L, Vieth M, Gibson F, Nagy P, Kahrilas PJ. Systematic review: the effects of long-term proton pump inhibitor use on serum gastrin levels and gastric histology. Aliment Pharmacol Ther 2015;42:649-63. doi: 10.1111/apt.13324.
  • Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther 2011;34:1269-81. doi: 10.1111/j.1365-2036.2011.04874.x.
  • Shih CJ, Chen YT, Ou SM, Li SY, Chen TJ, Wang SJ. Proton pump inhibitor use represents an independent risk factor for myocardial infarction. Int J Cardiol 2014;177:292–7. doi: 10.1016/j.ijcard.2014.09.036.
  • Amato MC, Giordano C, Galia M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010 ;33:920-2. doi: 10.2337/dc09-1825.
  • Shikata T, Sasaki N, Ueda M, et al. Use of proton pump inhibitors is associated with anemia in cardiovascular outpatients. Circ J 2015;79:193-200. doi: 10.1253/circj.CJ-14- 0582.
  • Ding Y, Jia Y, Song Y, et al. The effect of lansoprazole, an OCT inhibitor, on metformin pharmacokinetics in healthy subjects. Eur J Clin Pharmacol 2014 ;70:141-6. doi: 10.1007/ s00228.013.1604-7.
  • Imhann F, Bonder MJ, Vich Vila A, et al. Proton pump inhibitors affect the gut microbiome. Gut 2016;65:740-8. doi: 10.1136/gutjnl-2015-310376.
  • Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-81. doi: 10.1097/00000.478.199610000-00001.
  • Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep 2010;12:448-57.
  • Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013;310:2435-42. doi: 10.1001/ jama.2013.280490.
  • Clarke G, Stilling RM, Kennedy PJ, Stanton C, Cryan JF, Dinan TG. Minireview: Gut microbiota: the neglected endocrine organ. Mol Endocrinol 2014;28:1221-38. doi: 10.1210/ me.2014-1108.
  • Burmeister MA, Smith TE, Fincher TK, Weldon AJ. Evidence for proton-pump inhibitor (PPI)-associated dysbiosis in metabolically unhealthy obesity. Front Endocrinol (Lausanne). 2023;14:1205490. doi: 10.3389/fendo.2023.120.5490.
  • Czwornog JL, Austin GL. Association of proton pump inhibitor (PPI) use with energy intake, physical activity, and weight gain. Nutrients 2015;7:8592-601. doi: 10.3390/ nu7105416.
  • Yoshikawa I, Nagato M, Yamasaki M, Kume K, Otsuki M. Long-term treatment with proton pump inhibitor is associated with undesired weight gain. World J Gastroenterol 2009;15:4794-8. doi: 10.3748/wjg.15.4794.
  • Agrawal H, Aggarwal K, Jain A. Visceral Adiposity Index: Simple tool for assessing cardiometabolic risk in women with polycystic ovary syndrome. Indian J Endocrinol Metab 2019;23:232-7. doi: 10.4103/ijem.IJEM_559_18.
  • Kim B, Jung JH, Han K, et al. Histamine-2 Receptor antagonists and proton pump inhibitors are associated with reduced risk of SARS-CoV-2 infection without comorbidities including diabetes, hypertension, and dyslipidemia: A propensity score-matched nationwide cohort study. J Korean Med Sci 2023;38:e99. doi: 10.3346/jkms.2023.38.e99.
  • Imperatore N, Tortora R, Testa A, Gerbino N, Caporaso N, Rispo A. Proton pump inhibitors as risk factor for metabolic syndrome and hepatic steatosis in coeliac disease patients on gluten-free diet. J Gastroenterol 2018;53:507-16. doi: 10.1007/ s00535.017.1381-7.
  • Ali HS, Jabbar AS, Neamah NK, Ibrahim NK. Long-term use of omeprazole: Effect on haematological and biochemical parameters. Acta Med Indones 2022;54:585-94.
  • Abdullah E, Dhiaa S, Saleh K, Merkhan M M. Effect of esomeprazole on lipid profile in patients with peptic ulcer. Pharmacia 2021;68:613. doi: 10.3897/pharmacia.68.e70292
  • Wakabayashi T, Hosohata K, Oyama S, et al. Association between a low dose of proton pump inhibitors and kidney function decline in elderly hypertensive patients: a retrospective observational study. J Int Med Res 2021;49:1-8. doi: 10.1177/03000605211006653
  • Yang B, Li M, Yu H, et al. Proton pump inhibitor use is associated with increased liver steatosis Biomed Rep. 2024;21:116. doi: 10.3892/br.2024.1804

Year 2025, Volume: 38 Issue: 3, 227 - 231, 10.10.2025
https://doi.org/10.5472/marumj.1800011

Abstract

References

  • Forgacs I, Loganayagam A. Overprescribing proton pump inhibitors. BMJ 2008;336:2-3. doi: 10.1136/bmj.39406.449456. BE.
  • Scarpignato C, Gatta L, Zullo A, et al. Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression. BMC Med 2016;14:179. doi: 10.1186/ s12916.016.0718-z.
  • Metz DC. Long-term use of proton-pump inhibitor therapy. Gastroenterol Hepatol (N Y) 2008;4:322-5.
  • Lundell L, Vieth M, Gibson F, Nagy P, Kahrilas PJ. Systematic review: the effects of long-term proton pump inhibitor use on serum gastrin levels and gastric histology. Aliment Pharmacol Ther 2015;42:649-63. doi: 10.1111/apt.13324.
  • Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther 2011;34:1269-81. doi: 10.1111/j.1365-2036.2011.04874.x.
  • Shih CJ, Chen YT, Ou SM, Li SY, Chen TJ, Wang SJ. Proton pump inhibitor use represents an independent risk factor for myocardial infarction. Int J Cardiol 2014;177:292–7. doi: 10.1016/j.ijcard.2014.09.036.
  • Amato MC, Giordano C, Galia M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010 ;33:920-2. doi: 10.2337/dc09-1825.
  • Shikata T, Sasaki N, Ueda M, et al. Use of proton pump inhibitors is associated with anemia in cardiovascular outpatients. Circ J 2015;79:193-200. doi: 10.1253/circj.CJ-14- 0582.
  • Ding Y, Jia Y, Song Y, et al. The effect of lansoprazole, an OCT inhibitor, on metformin pharmacokinetics in healthy subjects. Eur J Clin Pharmacol 2014 ;70:141-6. doi: 10.1007/ s00228.013.1604-7.
  • Imhann F, Bonder MJ, Vich Vila A, et al. Proton pump inhibitors affect the gut microbiome. Gut 2016;65:740-8. doi: 10.1136/gutjnl-2015-310376.
  • Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-81. doi: 10.1097/00000.478.199610000-00001.
  • Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep 2010;12:448-57.
  • Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013;310:2435-42. doi: 10.1001/ jama.2013.280490.
  • Clarke G, Stilling RM, Kennedy PJ, Stanton C, Cryan JF, Dinan TG. Minireview: Gut microbiota: the neglected endocrine organ. Mol Endocrinol 2014;28:1221-38. doi: 10.1210/ me.2014-1108.
  • Burmeister MA, Smith TE, Fincher TK, Weldon AJ. Evidence for proton-pump inhibitor (PPI)-associated dysbiosis in metabolically unhealthy obesity. Front Endocrinol (Lausanne). 2023;14:1205490. doi: 10.3389/fendo.2023.120.5490.
  • Czwornog JL, Austin GL. Association of proton pump inhibitor (PPI) use with energy intake, physical activity, and weight gain. Nutrients 2015;7:8592-601. doi: 10.3390/ nu7105416.
  • Yoshikawa I, Nagato M, Yamasaki M, Kume K, Otsuki M. Long-term treatment with proton pump inhibitor is associated with undesired weight gain. World J Gastroenterol 2009;15:4794-8. doi: 10.3748/wjg.15.4794.
  • Agrawal H, Aggarwal K, Jain A. Visceral Adiposity Index: Simple tool for assessing cardiometabolic risk in women with polycystic ovary syndrome. Indian J Endocrinol Metab 2019;23:232-7. doi: 10.4103/ijem.IJEM_559_18.
  • Kim B, Jung JH, Han K, et al. Histamine-2 Receptor antagonists and proton pump inhibitors are associated with reduced risk of SARS-CoV-2 infection without comorbidities including diabetes, hypertension, and dyslipidemia: A propensity score-matched nationwide cohort study. J Korean Med Sci 2023;38:e99. doi: 10.3346/jkms.2023.38.e99.
  • Imperatore N, Tortora R, Testa A, Gerbino N, Caporaso N, Rispo A. Proton pump inhibitors as risk factor for metabolic syndrome and hepatic steatosis in coeliac disease patients on gluten-free diet. J Gastroenterol 2018;53:507-16. doi: 10.1007/ s00535.017.1381-7.
  • Ali HS, Jabbar AS, Neamah NK, Ibrahim NK. Long-term use of omeprazole: Effect on haematological and biochemical parameters. Acta Med Indones 2022;54:585-94.
  • Abdullah E, Dhiaa S, Saleh K, Merkhan M M. Effect of esomeprazole on lipid profile in patients with peptic ulcer. Pharmacia 2021;68:613. doi: 10.3897/pharmacia.68.e70292
  • Wakabayashi T, Hosohata K, Oyama S, et al. Association between a low dose of proton pump inhibitors and kidney function decline in elderly hypertensive patients: a retrospective observational study. J Int Med Res 2021;49:1-8. doi: 10.1177/03000605211006653
  • Yang B, Li M, Yu H, et al. Proton pump inhibitor use is associated with increased liver steatosis Biomed Rep. 2024;21:116. doi: 10.3892/br.2024.1804
There are 24 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Original Research
Authors

Ufuk Kutluana 0000-0002-2323-5756

Publication Date October 10, 2025
Submission Date June 24, 2025
Acceptance Date August 13, 2025
Published in Issue Year 2025 Volume: 38 Issue: 3

Cite

APA Kutluana, U. (2025). The effect of long-term proton pump inhibitor use on the visceral adiposity index. Marmara Medical Journal, 38(3), 227-231. https://doi.org/10.5472/marumj.1800011
AMA Kutluana U. The effect of long-term proton pump inhibitor use on the visceral adiposity index. Marmara Med J. October 2025;38(3):227-231. doi:10.5472/marumj.1800011
Chicago Kutluana, Ufuk. “The Effect of Long-Term Proton Pump Inhibitor Use on the Visceral Adiposity Index”. Marmara Medical Journal 38, no. 3 (October 2025): 227-31. https://doi.org/10.5472/marumj.1800011.
EndNote Kutluana U (October 1, 2025) The effect of long-term proton pump inhibitor use on the visceral adiposity index. Marmara Medical Journal 38 3 227–231.
IEEE U. Kutluana, “The effect of long-term proton pump inhibitor use on the visceral adiposity index”, Marmara Med J, vol. 38, no. 3, pp. 227–231, 2025, doi: 10.5472/marumj.1800011.
ISNAD Kutluana, Ufuk. “The Effect of Long-Term Proton Pump Inhibitor Use on the Visceral Adiposity Index”. Marmara Medical Journal 38/3 (October2025), 227-231. https://doi.org/10.5472/marumj.1800011.
JAMA Kutluana U. The effect of long-term proton pump inhibitor use on the visceral adiposity index. Marmara Med J. 2025;38:227–231.
MLA Kutluana, Ufuk. “The Effect of Long-Term Proton Pump Inhibitor Use on the Visceral Adiposity Index”. Marmara Medical Journal, vol. 38, no. 3, 2025, pp. 227-31, doi:10.5472/marumj.1800011.
Vancouver Kutluana U. The effect of long-term proton pump inhibitor use on the visceral adiposity index. Marmara Med J. 2025;38(3):227-31.