The effect of long-term proton pump inhibitor use on the visceral adiposity index

Objective: To investigate whether long-term proton pump inhibitor (PPI) use (≥3 years) is associated with changes in visceral adiposity index (VAI) and lipid profile Patients and Methods: Between September 2020 and May 2022, 51 long-term PPI users (PG) and 75 age – and sex-matched controls (CG) were enrolled. Demographics, waist circumference (WC), body mass index (BMI), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and VAI (calculated via validated sex-specific formulas) were recorded. Statistical analysis was performed using SPSS 23.0 with independent t-test/Mann–tests and logistic regression. Results: The PG exhibited significantly higher WC (97.1 ± 19.8 vs. 90.1 ± 16.7 cm; p=0.036), TG (148.8 ± 58.3 vs. 125.8 ± 48.6 mg/dL; p=0.018), and VAI (2.74 ± 1.59 vs. 2.12 ± 1.47; p=0.028) compared to controls. HDL-C and LDL-C differences were not significant. Male sex approached borderline significance as a predictor of elevated VAI in regression analysis. Conclusion: Long-term PPI use is associated with increased WC, TG, and VAI despite no significant changes in HDL-C or LDL-C, suggesting a potential metabolic risk. Clinicians should consider this when prescribing PPIs; prospective large population based studies are warranted.