Risk factors for peptic ulcer disease: a population based prospective cohort study comprising 2416 Danish adults.
BACKGROUND
No population based prospective cohort study has previously assessed the impact of multiple risk factors, including Helicobacter pylori infection, on the incidence of peptic ulcer disease (PUD).


OBJECTIVE
To identify risk factors for PUD and estimate their relative impact on ulcer incidence.


METHODS
Random sample of 2416 Danish adults with no history of PU.


METHODS
Sample members were interviewed in 1982 and 1994. PUs diagnosed within the observation period were verified through medical records. Information on psychosocial factors, lifestyle practices, and medication was obtained from a questionnaire completed at study entry. H pylori infection status was determined by ELISA.


RESULTS
The main risk factors for PUD were H pylori infection (odds ratio 4.3 (95% confidence interval 2.2; 8.3)), tobacco smoking (3.8 (1.7; 9.8)), and use of minor tranquillisers (3.0 (1.4; 6.6)). Intake of non-steroid anti-inflammatory drugs did not affect the incidence of PUD (0.4 (0.1; 2.3)). In those with increased antibodies to H pylori, tobacco smoking (12.7 (2.8; 56.8)) and intake of spirits (2.4 (1.1; 5.4)) increased the risk of PUD whereas moderate leisure time physical activity (0.3 (0.2; 0.7)) protected against PUD.


CONCLUSIONS
Tobacco smoking and H pylori infection are the main risk factors for PUD in Danish adults. Physical activity may protect against PUD in those infected with H pylori.
Rosenstock
S
S
Copenhagen County Centre for Preventive Medicine, Glostrup University Hospital, Building 8.7. Nordre Ringvej, DK 2600 Glostrup, Denmark. rosenstock.s@dadlnet.dk
Jørgensen
T
T
Bonnevie
O
O
Andersen
L
L
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D003069:Coffee / Q000009:adverse effects; D003718:Denmark / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions; D004381:Duodenal Ulcer / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000209:etiology; D012907:Smoking / Q000009:adverse effects; D013276:Stomach Ulcer / Q000453:epidemiology
D003069:Coffee; D007074:Immunoglobulin G