Cc. Wang et al., Helicobacter pylori infection and age on the development of intestinal metaplasia - A multiple logistic regression analysis, HEP-GASTRO, 45(24), 1998, pp. 2234-2237
BACKGROUND/AIMS: Both intestinal metaplasia (IM) and Helicobacter pylori (H
. pylori) infection have been Linked to gastric carcinogenesis in an age-de
pendent manner. However, their relationship remains ill defined, especially
with respect to age.
METHODOLOGY: Three hundred and two asymptomatic subjects (167 males and 135
females; mean age 44.3+/-11.1 years) underwent complete endoscopic examina
tion and biopsy at the antrum and the corpus. H. pylori infection was diagn
osed according to histopathology and serology, while IM was determined by h
istopathology.
RESULTS: Eighty-four patients (27.8%) had IM, while 185 patients (61.3%) we
re seropositive to H. pylori. The frequency of IM was higher in patients wi
th gastric ulcer (9/14, 64.3%) than in those with minimal change (68/229, 2
9.7%) or duodenal ulcer (7/59, 11.9%), both p<0.01. Patients with IM had a
higher mean age (49.5+/-14.1 vs. 42.3+/-9.0, p<0.01) and a higher H. pylori
prevalence than those without IM (61/84, 72.6% vs. 124/218, 56.9%, p<0.01)
. The concordance rate of H. pylori infection between histopathologic and s
erologic diagnosis was lower in patients with IM (67/84, 79.8%) than those
without (196/218, 89.9% p<0.05). Using logistic regression analyses, the de
velopment of IM was noted to be independently related to both H. pylori inf
ection (odds ratio=1.97, 95% confidence interval: 1.1(3.53)) and age (odds
ratio=1.93, 95% confidence interval: 1.51(2.47)),
CONCLUSIONS: These data suggest that age and H. pylori infection are indepe
ndent risk factors for the development of IM. Furthermore, H. pylori infect
ion may have been underestimated in patients with IM because of the use of
a single method of detection.