Abstract
Proton pump inhibitors (PPIs) are widely used against gastroesophageal reflux disease. Recent epidemiological studies suggest that PPI users have an increased risk of fractures, but a causal relationship has been questioned. We have therefore investigated the skeletal phenotype in H^+^/K^+^ATPase beta‐subunit knockout (KO) female mice. Skeletal parameters were determined in 6‐ and 20‐month‐old KO mice and in wild‐type controls (WT). Whole body bone mineral density (BMD) and bone mineral content (BMC) were measured by dual energy X‐ray absorptiometry (DXA). Femurs were examined with µCT analyses and break force were examined by a three‐point bending test. Plasma levels of gastrin, RANKL, OPG, osteocalcin, leptin, and PTH were analyzed. KO mice had lower whole body BMC at 6 months (0.53 vs. 0.59 g, P = 0.035) and at 20 months (0.49 vs. 0.74 g, P < 0.01) compared to WT as well as lower BMD at 6 months (0.068 vs. 0.072 g/cm^2^, P = 0.026) and 20 months (0.067 vs. 0.077 g/cm^2^, P < 0.01). Mechanical strength was lower in KO mice at the age of 20 months (6.7 vs. 17.9 N, P < 0.01). Cortical thickness at 20 months and trabecular bone volume% at 6 months were significantly reduced in KO mice. Plasma OPG/RANKL ratio and PTH was increased in KO mice compared to controls. H^+^/K^+^ATPase beta subunit KO mice had decreased BMC and BMD, reduced cortical thickness and inferior mechanical bone strength. Whereas the mechanism is uncertain, these findings suggest a causal relationship between long‐term PPI use and an increased risk of fractures. J. Cell. Biochem. 113: 141–147, 2012. © 2011 Wiley Periodicals, Inc.