title: Should increased levels of urinary 8-hydroxydeoxyguanosine in chronic gastritis imply intestinal metaplasia or gastric atrophy?
abstract: OBJECTIVE
  Helicobacter pylori (H pylori) infection induces chronic inflammation that can progress to gastric atrophy, intestinal metaplasia, and gastric adenocarcinoma. We have examined oxidative damage caused by Helicobacter pylori, metaplasia, and atrophy of gastric mucosal cells in patients with chronic gastritis by measuring their urinary 8-hydroxydeoxyguanosine (8-OHdG) levels.
  
  
  METHODS
  We recruited 77 outpatients with chronic gastritis, confirmed by endoscopic examination. H pylori status was evaluated by histology (modified Giemsa staining), the H pylori stool antigen test (n=20), and the 13C urea breath test (n=27), as described in the Maastricht consensus report.
  
  
  RESULTS
  The mean amount of 8-OHdG (microg/g creatinine) in 77 subjects was 18.07 +/- 13.49 x 10(-3) microg/g creatinine. The levels of urinary 8-OHdG in the H pylori-positive gastritis patients were also significantly higher than those in the H pylori-negative gastritis patients (P=0.003, respectively, 20.42 +/- 13.33 x 10(-3) microg/g creatinine, 13.16 +/- 12.71 x 10(-3) microg/g creatinine). The level of urinary 8-OHdG was markedly higher in patients with gastric atrophy and intestinal metaplasia than in those without (P=0.000, P=0.002, respectively). There were significant correlations between levels of urinary 8-OHdG and both the atrophy score (r=0.441, P=0.000) and the intestinal metaplasia score (r=0.436, P=0.000).
  
  
  CONCLUSIONS
  Urinary 8-OHdG levels could be investigated in every patient with chronic gastritis, since it is a simple and completely noninvasive procedure. In patients with high levels of urinary 8-OHdG, endoscopic procedures or even pathological investigation may then be carried out, with the consideration that there is a high risk of intestinal metaplasia or atrophy.
authors.affiliation: Department of Internal Medicine, Ataturk University, Erzurum, Turkey. fatihalbayrakerz@gmail.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Albayrak
authors.forename: Muhammet H
authors.initials: MH
authors.lastname: Uyanik
authors.forename: Hakan
authors.initials: H
authors.lastname: Dursun
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Albayrak
authors.forename: Sare
authors.initials: S
authors.lastname: Altas
authors.forename: Abdullah
authors.initials: A
authors.lastname: Uyanik
authors.forename: Serkan
authors.initials: S
authors.lastname: Cerrah
authors.forename: Yasin
authors.initials: Y
authors.lastname: Bayir
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D001284:Atrophy / Q000209:etiology / Q000652:urine; D002908:Chronic Disease; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000652:urine; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000150:complications / Q000652:urine*; D016481:Helicobacter Infections / Q000150:complications / Q000652:urine; D016480:Helicobacter pylori; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000209:etiology / Q000652:urine; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine