Determinants for the development of chronic atrophic gastritis and intestinal metaplasia in the stomach.
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)
Farinati
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F
Cattedra Malattie Aparato Digerente, Istituto di Medicina Interna, Policlinico Universitario, Padova, Italy.
Cardin
R
R
Libera
G D
GD
Rugge
M
M
Herszènyi
L
L
Di Mario
F
F
Molari
A
A
Plebani
M
M
Naccarato
R
R
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
D008315:Malondialdehyde; D001205:Ascorbic Acid