{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:04:35Z","timestamp":1777874675312,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Proton pump inhibitor (PPI)\u2010induced hypochondria can change the composition of the gut microbiota, inducing overgrowth of small bowel bacteria, which has been suggested to promote the development of fatty liver disease through the gut\u2010liver axis. In this study, we aimed to investigate the association between PPI use and the risk of fatty liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted using the Korean National Health Insurance Service\u2010National Sample Cohort, a nationwide population\u2010based representative sample, from January 1, 2002, to December 31, 2015. PPI use was identified from treatment claims and considered as a time\u2010varying variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 1\u00a0463\u00a0556 person\u2010years of follow\u2010up, 75\u00a0727 patients had at least one PPI prescription, and 3735 patients developed fatty liver disease. The hazard ratio for fatty liver disease comparing PPI users with non\u2010PPI users was 1.68 (95% confidence interval, 1.61\u20131.75). When adjusted for multiple confounders, including age, sex, body mass index, smoking, alcohol intake, exercise, income level, and comorbidities, the association was still significant (hazard ratio, 1.50; 95% confidence interval, 1.44\u20131.57). After considering the amounts of PPIs stratified by cumulative defined daily dose, the dose\u2013response effect was observed until 180\u00a0days. Subgroup analysis also revealed that PPI use was correlated to an increased risk of fatty liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This current national wide cohort study suggests that PPI use was associated with an increased risk of fatty liver disease compared with non\u2010use of PPIs. Clinicians should consider fatty liver as a potential risk when prescribing PPI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15236","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T18:06:36Z","timestamp":1599242796000},"page":"1235-1243","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Proton pump inhibitors use and the risk of fatty liver disease: A nationwide cohort study"],"prefix":"10.1111","volume":"36","author":[{"given":"Jeung Hui","family":"Pyo","sequence":"first","affiliation":[{"name":"Center for Health Promotion, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-9034","authenticated-orcid":false,"given":"Tae Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4271-7205","authenticated-orcid":false,"given":"Hyuk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Chul","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Health Promotion, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo\u2010Jin","family":"Cho","sequence":"additional","affiliation":[{"name":"Center for Health Promotion, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoon\u2010Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Health Promotion, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang Won","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung\u2010Hoon","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Haeng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minwoong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Digital Health, SAIHST, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeong Chan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Digital Health, SAIHST, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae J","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, School of Medicine Sungkyunkwan University  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl15502"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2018.29"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.46"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00268.2014"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000481813"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-313312"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.12.011"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.007"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl16477"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-00796-x"},{"key":"e_1_2_5_12_1","first-page":"e15","article-title":"Cohort profile: the National Health Insurance Service\u2010National Sample Cohort (NHIS\u2010NSC), South Korea","volume":"46","author":"Lee J","year":"2017","journal-title":"Int. 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