title: Biologic sex as a risk factor for Helicobacter pylori infection in healthy young adults.
abstract: Diseases associated with Helicobacter pylori infection, such as peptic ulcer disease and gastric cancer, afflict men more frequently than women. No study, however, has demonstrated any difference in sex-specific rates of H. pylori infection. In a healthy population undergoing multiphasic health evaluations in 1992-1993 as members of the Kaiser Permanente Medical Care Program of Northern California, adults aged 20-39 years were screened for antibodies to H. pylori infection using a serum enzyme-linked immunosorbent assay and were surveyed with regard to their demographic characteristics and health practices. Among 556 African-American, Hispanic, and white men and women, male sex was a significant risk factor for infection. Other risk factors included African-American race and Hispanic ethnicity, increasing age, living with children, birth in a developing country, and lower levels of income and education. Men consistently had a higher prevalence of antibodies across all strata of race/ethnicity, age, education, and income, and in multivariate analysis male sex remained significantly associated with infection (odds ratio = 2.0, 95% confidence interval 1.2-3.1). African-American race, Hispanic ethnicity, increasing age, lower levels of education, and birth in a developing country were also associated with infection in multivariate analysis. Data from previously reported seroprevalence studies support a tendency for men to have a higher risk of infection. The higher prevalence of infection among young males as observed in Northern California may account in part for the increased incidence of H. pylori-related diseases among men in later decades of life.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, CA 94305-5092, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Replogle
authors.forename: S L
authors.initials: SL
authors.lastname: Glaser
authors.forename: R A
authors.initials: RA
authors.lastname: Hiatt
authors.forename: J
authors.initials: J
authors.lastname: Parsonnet
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D017678:Sex Distribution
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G