PP409 - THE HIDDEN THREAT: PPI USE AND SARCOPENIC OBESITY IN OLDER ADULTS WITH DIABETES

PP409

THE HIDDEN THREAT: PPI USE AND SARCOPENIC OBESITY IN OLDER ADULTS WITH DIABETES

Ö. Geridönmez^1,*, B. Kelleci Çakır¹, A. Okyar Baş², C. Balcı³, K. Demirkan¹, M. G. Halil³

¹Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, ²Division of Geriatrics, Ankara Training and Research Hospital, ³Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Türkiye

Rationale: Proton pump inhibitors (PPIs) are among the most frequently prescribed medications in the geriatric population. PPI use has been linked to micronutrient deficiencies (e.g., vitamin B12, calcium), which are associated with frailty and sarcopenia. This study aimed to evaluate the association between PPI use and sarcopenic obesity (SO), which may share inflammation- and micronutrient-related mechanisms.

Methods: SO was defined per ESPEN/EASO criteria using BMI or waist circumference for screening, low muscle strength (HGS <27/16 kg or chair stand <15 s), and abnormal body composition (Fat% >31/43 and SMM/W <25.7/19.4 for men/women) using BIA. Nutritional status was assessed via the MNA-SF, and clinical frailty was measured using the CFS.

Results: A retrospective analysis was conducted on 151 diabetic patients (admitted to a geriatrics outpatient clinic of a tertiary care hospital. The overall prevalence of SO was 28.5% (n=43). Among patients diagnosed with SO, 58.1% (n=25) were receiving PPI therapy (p<0.001). PPI use was significantly associated with a higher risk of SO (OR: 4.72, 95% CI: 1.57–14.14, p=0.006). After adjusting for potential confounders, including age, sex, MNA-SF, and CFS, patients utilizing PPIs were 4.7 times more likely to present sarcopenic obesity.

Conclusion: PPI use is a significant and independent risk factor for SO in older adults with diabetes. Evidence suggests that PPI use may contribute to muscle mass loss and increased adiposity through mechanisms. These findings highlight the critical need for multidisciplinary collaboration between physicians and pharmacists to conduct regular medication reviews and implement deprescribing strategies to prevent adverse metabolic and functional outcomes in this population.

Disclosure of Interest: None declared