Table 1.

Overview of the different effect of proton pump inhibitors on bone health. BMD: bone mineral density, DXA: dual energy X-ray analysis, Micro CT: micro computed tomography, pQCT: high-resolution peripheral quantitative peripheral.

PPI	Animal Studies	Human Studies
Biological plausibility	Increase of bone resorption Decrease of osteoclast vacuolar V+-ATPase	Decrease of osteoclast vacuolar H+-ATPase Hypergastrinemia Decrease of quality of collagen Increase of bone resorption
Bone Mineral Density (DXA)	Decrease of femoral BMD	Inconsistent data
Bone quality	Decrease of trabecular thickness (micro CT)	Decrease of trabecular bone density (pQCT) Decrease of Trabecular Bone Score (DXA)
Frequency of falls	-	Increased risk of fall
Epidemiological data on fragility fracture	-	Increased risk of fragility fracture