Antral mucosal Helicobacter pylori infection density as a risk factor of duodenal ulcer.
OBJECTIVE
Duodenal ulcer is regarded as the end result of alterations in which Helicobacter pylori (HP) plays a major role as a pathogenetic agent. The aim of this prospective study was to evaluate duodenal ulcer risk factors such as alcohol intake, smoking, use of non-steroidal anti-inflammatory drugs, age and sex in relation to HP colonization density.


METHODS
495 patients consecutively examined by diagnostic upper digestive endoscopy were assessed; none of them had had previous upper digestive endoscopy or peptic ulcer, recent anticulcer-antibiotic treatment, upper gastrointestinal surgery, or cancer. The HP colonization on antral bioptic specimens was graded semi-quantitatively as follows: HP--- (absence of HP); HP+--(focal presence of small amounts of HP); HP++- (intermediate situation between HP+-- and HP+++), and HP+++ (diffuse presence of large amounts of HP).


RESULTS
Logistic regression analysis identified only male sex (odds ratio 1.88, p < 0.02), smoking more than 10 cigarettes/day (odds ratio 2.53, p < 0.01), and 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.


CONCLUSIONS
The duodenal ulcer risk was found to correlate with HP density, male sex, and smoking, but not with non-steroidal anti-inflammatory drug use.
Talamini
G
G
Gastroenterology Unit, University of Verona, Italy.
Zamboni
G
G
Cavallini
G
G
D000428:Alcohol Drinking; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001706:Biopsy; D015169:Colony Count, Microbial; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000382:microbiology*; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000382:microbiology* / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D000894:Anti-Inflammatory Agents, Non-Steroidal