Antihistamine Therapy and Bone Mineral Density: Analysis in a Population-Based US Sample

Abstract

Background Histamine may play an important role in bone turnover. The data regarding histamine 1 receptor antagonist (H1RA), histamine 2 receptor antagonist (H2RA), and bone mineral density in humans are sparse. We examined bone mineral density in subjects using histamine receptor antagonists in a representative US population-based sample from the Third National Health and Nutrition Examination Survey (1988-1994). Methods Adult subjects aged 60 years and more using H1RA or H2RA who underwent dual energy x-ray absorptiometry scanning in the Third National Health and Nutrition Examination Survey were identified. We compared the femoral neck bone mineral density among users of these agents with nonusers in adjusted linear regression models that included known demographic, anthropometric, and medical risk factors for osteoporosis. Results The mean age of the study subjects was 72.6 years; 52% were women and 59% were white. Among subjects with femoral neck bone mineral density measured, 199 used H1RAs, 297 used H2RAs, and 4162 were nonusers of histamine receptor antagonists. Femoral neck bone mineral density adjusting for age and gender and other covariates was slightly higher in H1RA users (0.74 g/cm 2) versus nonusers (0.72 g/cm 2; P = .037). H2RA users showed slightly lower adjusted bone mineral density compared with nonusers (0.69 g/cm 2 vs 0.72 g/cm 2; P = .003), but bone densities were similar between H2RA users and nonusers when daily calcium intake exceeded 800 mg per day. Conclusion Femoral neck bone mineral density may be higher in H1RA users than nonusers among older adults. H2RA users with reduced calcium intake had lower bone mineral density than nonusers.