Kinjo M, Setoguchi S, Solomon DH.
Okinawa Chubu Hospital, Okinawa, Japan.
Am J Med 2008;121:1085–91.
Editor’s note: Several clinical observations suggest that histamine may have a role in bone turnover. Chronic medical conditions associated with high histamine production, such as mastocytosis, are associated with increased bone absorption and osteoporosis. Many people take drugs that block histamine uptake, either for allergies (histamine 1 receptor antagonists [H1RAs]) or for peptic ulcer disease and gastrointestinal problems (histamine 2 receptor antagonists [H2RAs]). In this large US population survey, adults aged
>60 years who underwent dual energy X-ray absorptiometry scanning were identified. Within this population, patients receiving either H1RAs or H2RAs were identified, and their femoral neck bone mineral density (BMD) was compared with non-users. Altogether, 4162 non-users, 199 H1RA users, and 297 H2RA users were studied. Femoral neck BMD was comparable between H1RA users and non-users; however, after adjustment for covariates including age, gender, comorbidity, and steroid use, there was a trend towards higher BMD in H1RA users (p=0.037). In H2RAs users, femoral neck BMD was significantly lower than in non-users (p=0.003). The reduction in BMD seen in patients taking H2RAs was particularly noted in those with a low daily calcium and/or vitamin D intake.