title: Age, smoking and overweight contribute to the development of intestinal metaplasia of the cardia.
abstract: OBJECTIVE
  To assess the role of Helicobacter pylori (H. pylori), gastroesophageal reflux disease (GERD), age, smoking and body weight on the development of intestinal metaplasia of the gastric cardia (IMC).
  
  
  METHODS
  Two hundred and seventeen patients scheduled for esophagogastroduodenoscopy were enrolled in this study. Endoscopic biopsies from the esophagus, gastroesophageal junction and stomach were evaluated for inflammation, the presence of H. pylori and intestinal metaplasia. The correlation of these factors with the presence of IMC was assessed using logistic regression.
  
  
  RESULTS
  IMC was observed in 42% of the patients. Patient age, smoking habit and body mass index (BMI) were found as potential contributors to IMC. The risk of developing IMC can be predicted in theory by combining these factors according to the following formula: Risk of IMC = a + s - 2B where a = 2,…6 decade of age, s = 0 for non-smokers or ex-smokers, 1 for < 10 cigarettes/d, 2 for > 10 cigarettes/d and B = 0 for BMI < 25 kg/m² (BMI < 27 kg/m² in females), 1 for BMI > 25 kg/m² (BMI > 27 kg/m² in females). Among potential factors associated with IMC, H. pylori had borderline significance (P = 0.07), while GERD showed no significance.
  
  
  CONCLUSIONS
  Age, smoking and BMI are potential factors associated with IMC, while H. pylori and GERD show no significant association. IMC can be predicted in theory by logistic regression analysis.
authors.affiliation: Service of Gastroenterology, University Hospital, 1000 Lausanne, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Felley
authors.forename: Hanifa
authors.initials: H
authors.lastname: Bouzourene
authors.forename: Marianne Bründler G
authors.initials: MB
authors.lastname: VanMelle
authors.forename: Antoine
authors.initials: A
authors.lastname: Hadengue
authors.forename: Pierre
authors.initials: P
authors.lastname: Michetti
authors.forename: Gian
authors.initials: G
authors.lastname: Dorta
authors.forename: Laurent
authors.initials: L
authors.lastname: Spahr
authors.forename: Emiliano
authors.initials: E
authors.lastname: Giostra
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Frossard
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002299:Cardia / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D050177:Overweight / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000209:etiology