title: Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study.
abstract: OBJECTIVE
  The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
  
  
  METHODS
  From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed.
  
  
  RESULTS
  In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury.
  
  
  CONCLUSIONS
  H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kono
authors.affiliation: Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Internal Medicine, Tsuyama Chuo Hospital, Okayama, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Takenaka
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kanzaki
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hori
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Kita
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuzuki
authors.affiliation: Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kawahara
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D018450:Disease Progression; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors
keywords: Anti-inflammatory agents, non-steroidal; Gastric mucosal injury; Helicobacter pylori; Proton pump inhibitors