Long-term PPI use linked to higher NAFLD risk

Taking proton pump inhibitors for a long period of time appears to increase the risk of nonalcoholic fatty liver disease (NAFLD), particularly severe hepatic steatosis, reveals a US study.

This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) of 2017 to 2018. The investigators examined the association between PPI use and NAFLD risks using weighted multivariate logistic regression.

A total of 4,238 participants were included in this study, of whom 2,167 had a diagnosis of NAFLD. Multivariate analysis revealed the association of PPI use with a higher likelihood of developing NAFLD (odds ratio [OR], 1.318, 95 percent confidence interval [CI], 1.044‒1.663; p=0.020).

However, this association did not reach significance in participants taking PPIs for less than 5 years (OR, 0.846, 95 percent CI, 0.579‒1.238; p=0.390). The risk remained substantial only in those using PPIs for more than 5 years (OR, 2.016, 95 percent CI, 1.366‒2.975; p=0.031).

In further analysis, use of PPIs showed a positive correlation with the risks of severe hepatic steatosis (OR, 1.451, 95 percent CI, 1.034‒2.036; p=0.031) but not with mild-to-moderate steatosis (OR, 1.242, 95 percent CI, 0.886‒1.741; p=0.208).

“Awareness should be raised regarding the potential risks of NAFLD when prescribing PPIs,” the investigators said.