title: Determinants for the development of chronic atrophic gastritis and intestinal metaplasia in the stomach.
abstract: This study aimed to identify the factors associated with the development of gastric precancerous changes, in a prospective series of patients undergoing endoscopy. Risk factors and associated mucosal changes were evaluated in 134 endoscoped patients affected by chronic non-atrophic (n = 76) or atrophic gastritis (CAG) (n = 32), with or without intestinal metaplasia (IM), or lacking any major histological changes (n = 26). The following variables were taken into account: age, alcohol consumption, smoking habit, vitamin C intake (using a questionnaire), gastric juice vitamin C (HPLC on gastric juice samples obtained at endoscopy), H. pylori infection, gastric mucosa malondialdehyde (MDA; a measure of free radical production) and extent of CAG in gastric biopsies (only for IM). Tissue MDA levels were significantly higher, and vitamin C levels significantly lower in CAG and IM patients (P = 0.01). Multiple regression analysis showed significant correlations for: CAG vs age (P < 0.02), MDA (< 0.02) and gastric vitamin C (< 0.05); IM vs age (P < 0.0005), CAG (< 0.0005) and MDA (< 0.001). Using stepwise discrimination analysis, the independent variables included in the model were: for CAG, age (P < 0.003), MDA (< 0.05), gastric juice vitamin C (< 0.05); for IM, CAG (P < 0.0005), age (< 0.001), MDA (< 0.03) and vitamin C intake (< 0.05). H. pylori was not included. The major determinants for CAG and IM were age, free radical production (as measured by MDA), vitamin C (for CAG) and vitamin C intake and CAG (for IM).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Cattedra Malattie Aparato Digerente, Istituto di Medicina Interna, Policlinico Universitario, Padova, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Farinati
authors.forename: R
authors.initials: R
authors.lastname: Cardin
authors.forename: G D
authors.initials: GD
authors.lastname: Libera
authors.forename: M
authors.initials: M
authors.lastname: Rugge
authors.forename: L
authors.initials: L
authors.lastname: Herszènyi
authors.forename: F
authors.initials: F
authors.lastname: Di Mario
authors.forename: A
authors.initials: A
authors.lastname: Molari
authors.forename: M
authors.initials: M
authors.lastname: Plebani
authors.forename: R
authors.initials: R
authors.lastname: Naccarato
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D005750:Gastric Juice / Q000737:chemistry; D005753:Gastric Mucosa / Q000737:chemistry; D005757:Gastritis, Atrophic / Q000209:etiology*; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008679:Metaplasia / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D008315:Malondialdehyde; D001205:Ascorbic Acid