A POPULATION-BASED STUDY OF HELICOBACTER-PYLORI INFECTION IN A EUROPEAN COUNTRY - THE SAN-MARINO STUDY - RELATIONS WITH GASTROINTESTINAL-DISEASES

Helicobacter pylori is present worldwide but few large population stud ies exist on the epidemiology of the infection. A random cross section al study was performed of H pylori infection in the adult population o f San Marine, a European country with high gastric cancer rate, to ass ess its prevalence and to evaluate its relations with gastrointestinal disease. In 2237 subjects (77% of the initial sample) H pylori IgG an tibodies were detected with enzyme Linked immunosorbent assay (ELISA) and immunoblotting. A questionnaire including questions about occupati on, place of birth, and smoking was given to all subjects. Dyspepsia, peptic ulcer, and gastric cancer in the subjects, relatives, and partn ers as well as use of drug, dental treatment/prostheses, and gastroint estinal endoscopies, were evaluated by multivariate analysis. H pylori prevalence was of 51%, increased with age from 23% (20-29 years) to 6 8% (greater than or equal to 70 years), and was higher among manual wo rkers. H pylori was independently associated with ulcer (OR=1.63, 95% confidence intervals (CT)=1.16 to 2.27), H-2 antagonists (OR=1.94, 95% CI=1.21 to 3.10), and benzodiazepines (OR=1.57, 95% CI=1.02 to 2.42), dental prostheses (OR=1.25, 95% CI=1.05 to 1.49), gastroscopy in the past five years (OR=1.50, 95% CI=1.05 to 2.14), peptic ulcer in siblin gs (OR=1.52, 95% CI=1.09 to 2.12), gastric cancer in father (OR=1.61, 95% CI=1.02 to 2.52). The association of seropositivity with history o f ulcer, gastric cancer in family, gastroscopy, and Hz antagonists sug gests that H pylori is an epidemiological key factor in the pathogenes is of gastroduodenal diseases in this area.