Prevalence and risk factors of atrophic gastritis and intestinal metaplasia in a Korean population without significant gastroduodenal disease.
OBJECTIVE
The prevalence of gastric cancer and Helicobacter pylori infection is unacceptably high in Korea. This study was performed to evaluate the prevalence of atrophic gastritis (AG) and intestinal metaplasia (IM) and to identify their risk factors with respect to H. pylori virulence factors, and environmental and host factors, in Korean population without significant gastroduodenal disease.


METHODS
The study cohort consisted of 389 subjects (> or = 16 years). AG and IM were scored histologically using the Sydney classification in the antrum and body, respectively. Prevalences and bacterial factors (i.e. cagA, vacA m1, and oipA), environmental factors (i.e. smoking and alcohol), and host factors (i.e. genetic polymorphisms of IL-1B-511, IL-1RN, TNF-A-308, IL-10-592, IL-10-819, IL-10-1082, IL-8-251, IL-6-572, GSTP1, p53 codon 72, and ALDH2) were evaluated.


RESULTS
Prevalences of AG in the antrum and body were 42.5% and 20.1%, and those of IM were 28.6% and 21.2%, respectively. The presences of AG and IM were significantly higher in H. pylori-positive than in the H. pylori-negative subjects. Multivariate analysis showed that the risk factors for AG were H. pylori infection, age > or = 61 years, and cagA and vacA m1 positivity. For IM the risk factors were H. pylori infection, age > or = 61 years, a smoking history (rather than current smoking), strong spicy food, occupation (unemployed or nonprofessional vs. professional), and the presence of IL10-592 C/A as opposed to A/A. In addition, IL6-572 G carrier was found to have a protective effect against IM development as compared with C/C.


CONCLUSIONS
H. pylori infection was most important risk factor of AG and IM. Bacterial factors were found to be important risk factor for AG but environmental and host factors were more important for IM.
Kim
Nayoung
N
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, South Korea.
Park
Young Soo
YS
Cho
Sung-Il
SI
Lee
Hye Seung
HS
Choe
Gheeyoung
G
Kim
In Wook
IW
Won
Yoo-Deok
YD
Park
Ji Hyun
JH
Kim
Joo Sung
JS
Jung
Hyun Chae
HC
Song
In Sung
IS
D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People / Q000235:genetics / Q000523:psychology; D015331:Cohort Studies; D016207:Cytokines / Q000235:genetics / Q000276:immunology; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D016480:Helicobacter pylori / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D007422:Intestines / Q000276:immunology / Q000473:pathology*; D007723:Korea / Q000453:epidemiology; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000235:genetics / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D011110:Polymorphism, Genetic; D015995:Prevalence; D011706:Pyloric Antrum / Q000276:immunology / Q000473:pathology; D012307:Risk Factors; D037521:Virulence Factors / Q000235:genetics / Q000378:metabolism
D016207:Cytokines; D037521:Virulence Factors