title: Increase in the Prevalence of Atrophic Gastritis Among Adults Age 35 to 44 Years Old in Northern Sweden Between 1990 and 2009.
abstract: OBJECTIVE
  Atrophic corpus gastritis (ACG) is believed to be an early precursor of gastric adenocarcinoma. We aimed to investigate trends of ACG in Northern Sweden, from 1990 through 2009, and to identify possible risk factors.
  
  
  METHODS
  We randomly selected serum samples collected from 5284 participants in 1990, 1994, 1999, 2004, and 2009, as part of the population-based, cross-sectional Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study (ages, 35-64 y). Information was collected on sociodemographic, anthropometric, lifestyle, and medical factors using questionnaires. Serum samples were analyzed for levels of pepsinogen I to identify participants with functional ACG; data from participants with ACG were compared with those from frequency-matched individuals without ACG (controls). Blood samples were analyzed for antibodies against Helicobacter pylori and Cag pathogenicity island protein A. Associations were estimated with unconditional logistic regression models.
  
  
  RESULTS
  Overall, 305 subjects tested positive for functional ACG, based on their level of pepsinogen I. The prevalence of ACG in participants age 55 to 64 years old decreased from 124 per 1000 to 49 per 1000 individuals between 1990 and 2009. However, the prevalence of ACG increased from 22 per 1000 to 64 per 1000 individuals among participants age 35 to 44 years old during this time period. Cag pathogenicity island protein A seropositivity was associated with risk for ACG (odds ratio, 2.29; 95% confidence interval, 1.69-3.12). Other risk factors included diabetes, low level of education, and high body mass index. The association between body mass index and ACG was confined to individuals age 35 to 44 years old; in this group, overweight and obesity were associated with a 2.8-fold and a 4.7-fold increased risk of ACG, respectively.
  
  
  CONCLUSIONS
  Among residents of Northern Sweden, the prevalence of ACG increased from 1990 through 2009, specifically among adults age 35 to 44 years old. The stabilizing seroprevalence of H pylori and the increasing prevalence of overweight and obesity might contribute to this unexpected trend. Studies are needed to determine whether these changes have affected the incidence of gastric cancer.
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address: huan.song@ki.se.
authors: Huan
authors: H
authors: Song
authors: Department of Clinical Chemistry, Hallands Sjukhus Halmstad, Halmstad, Sweden.
authors: Maria
authors: M
authors: Held
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Sven
authors: S
authors: Sandin
authors: Department of Medical Sciences, Clinical Microbiology, Uppsala University, Uppsala, Sweden; Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors: Hilpi
authors: H
authors: Rautelin
authors: Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors: Mats
authors: M
authors: Eliasson
authors: Cardiology and Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors: Stefan
authors: S
authors: Söderberg
authors: Nutritional Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors: Göran
authors: G
authors: Hallmans
authors: Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors: Lars
authors: L
authors: Engstrand
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Olof
authors: O
authors: Nyrén
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Weimin
authors: W
authors: Ye
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
chemical_list: D020116:Pepsinogen A
keywords: BMI; MONICA Study; Secular Trend; Stomach