Association Between Long-Term Proton Pump Inhibitor Use and Deficiency of Vitamin B12 and Magnesium in Gharbia, Egypt: a Retrospective Study
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Abstract
Proton pump inhibitors (PPIs) are widely prescribed for acid-related disorders, but prolonged use has been implicated in nutrient malabsorption. Therefore, this study aimed to evaluate the association between long-term PPI use and deficiency of vitamin B12 and magnesium. Medical records for 312 adult patients with documented PPI use between January 2020 and January 2025 were reviewed. These patients were recruited from Tanta University Hospital and its affiliated centers in Gharbia Governorate, Egypt. Participants were stratified by PPI duration: <3 months, 3–6 months, 6–12 months, and >1 year. Serum vitamin B12 and magnesium were compared across groups. Multivariate regression was performed, adjusting for age, gender, comorbidities, and concomitant medications. Statistical significance was set at p<0.05. The results demonstrate that mean age was 58.7±12.4 years; 55% were male. Mean vitamin B12 levels significantly declined with longer PPI use (421.3 pg/mL in <3 months vs. 271.9 pg/mL in >1 year, p<0.001), as did magnesium levels (2.03 mg/dL vs. 1.69 mg/dL, p<0.001). Regression analysis confirmed that age, duration of PPI use, certain concomitant medications, and comorbidities were independent predictors of deficiency. Participants using PPIs for over 1 year had 11.6 times higher odds of B12 deficiency and 12.8 times higher odds of magnesium deficiency, with corresponding 95% CI, after adjustment. Altogether, long-term use of PPIs is significantly associated with deficiencies in both vitamin B12 and magnesium levels among patients in Gharbia Governorate, Egypt. The risk of deficiency increased with age and length of use, regardless of PPI type or sex of user.
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