ANTRAL MUCOSAL HELICOBACTER-PYLORI INFECTION DENSITY AS A RISK FACTOROF DUODENAL-ULCER

Objective: Duodenal ulcer is regarded as the end result of alterations in which Helicobactei-pylori (HP) plays a major role as a pathogeneti c agent. The aim of this prospective study was to evaluate duodenal ul cer risk factors such as alcohol intake, smoking, use of non-steroidal anti-inflammatory drugs, age and sex in relation to HP colonization d ensity. Patients and Methods. 495 patients consecutively examined by d iagnostic upper digestive endoscopy were assessed; none of them had ha d previous upper digestive endoscopy or peptic ulcer, recent antiulcer -antibiotic treatment, upper gastrointestinal surgery, or cancer. The HP colonization on antral bioptic specimens was graded semiquantitativ ely as follows: HP---(absence of HP); HP+--(focal presence of small am ounts of HP); HP++-(intermediate situation between HP+-- and HP+++), a nd HP+++ (diffuse presence of large amounts of HP). Results: Logistic regression analysis identified only male sex (odds ratio 1.88, p < 0.0 2), smoking more than 10 cigarettes/day (odds ratio 2.53, p < 0.01), a nd HP grade (HP+--odds ratio 0.79, p = NS; HP++-odds ratio 2.42, p < 0 .02; HP+++ odds ratio 3.66, p < 0.001) as independent risk factors of duodenal ulcer. Conclusion: The duodenal ulcer risk was found to corre late with HP density, male sex, and smoking, but not with non-steroida l anti-inflammatory drug use.