title: Associated factors of atrophic gastritis diagnosed by double-contrast upper gastrointestinal barium X-ray radiography: a cross-sectional study analyzing 6,901 healthy subjects in Japan.
abstract: BACKGROUND
  Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is one of the most widely conducted gastric cancer screening methods. It has been executed to find gastric cancer, but has not been usually executed to detect premalignant atrophic mucosa of stomach. To understand the meaning of UGI-XR-based atrophic gastritis, we analyzed its association with several causative factors including Helicobacter pylori (HP) infection.
  
  
  METHODS
  We evaluated 6,901 healthy adults in Japan. UGI-XR-based atrophic gastritis was diagnosed based on the irregular shape of areae gastricae and its expansion in the stomach.
  
  
  RESULTS
  Of the 6,433 subjects with no history of HP eradication and free from gastric acid suppressants, 1,936 were diagnosed as UGI-XR-based atrophic gastritis (mild: 234, moderate: 822, severe: 880). These were univariately associated with serum HP IgG and serum pepsinogen I/II ratio with statistical significance. The multiple logistic analysis calculating standardized coefficients (β) and odds ratio (OR) demonstrated that serum HP IgG (β = 1.499, OR = 4.48), current smoking (β = 0.526, OR = 1.69), age (β = 0.401, OR = 1.49), low serum pepsinogen I/II ratio (β = 0.339, OR = 1.40), and male gender (β = 0.306, OR = 1.36) showed significant positive association with UGI-XR-based atrophic gastritis whereas drinking and body mass index did not. Among the age/sex/smoking/drinking-matched 227 pairs derived from chronically HP-infected and successfully HP-eradicated subjects, UGI-XR-based atrophic gastritis was detected in 99.1% of the former but in only 59.5% of the latter subjects (p<0.0001). Contrastively, UGI-XR-based atrophic gastritis was detected in 13 of 14 HP-positive proton pump inhibitor users (92.9%) and 33 of 34 HP-positive histamine H2-receptor antagonist users (97.1%), which are not significantly different from gastric acid suppressant-free subjects.
  
  
  CONCLUSIONS
  The presence of UGI-XR-based atrophic gastritis is positively associated with Helicobacter pylori infection, current smoking, age, decreased serum pepsinogen I/II ratio, and male gender. Eradication of Helicobacter pylori seems to superficially improve UGI-XR-based atrophic gastritis whereas intake of gastric acid suppressants does not.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.affiliation: Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan.
authors.forename: Chigaya
authors.initials: C
authors.lastname: Hirano
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Minatsuki
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Nakayama
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Matsuda
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Konno-Shimizu
authors.affiliation: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kato
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochizuki
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sakaguchi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Itsuko
authors.initials: I
authors.lastname: Asada-Hirayama
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Takeuchi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Yakabi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kakimoto
authors.affiliation: Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Wada
authors.affiliation: Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsushima
authors.affiliation: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001464:Barium; D002908:Chronic Disease; D003287:Contrast Media; D003430:Cross-Sectional Studies; D004724:Endoscopy; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D064368:Healthy Volunteers; D016481:Helicobacter Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology; D016480:Helicobacter pylori / Q000502:physiology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011859:Radiography; D014965:X-Rays; D055815:Young Adult
chemical_list: D003287:Contrast Media; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D001464:Barium