High Salt Intake Is Associated with Atrophic Gastritis with Intestinal Metaplasia.
Background:Although several studies have investigated excessive salt intake as a risk factor for gastric precancerous lesions, such as atrophic gastritis and intestinal metaplasia, the evidence is insufficient to make a conclusion. We evaluated the association between gastric precancerous lesions and salt intake.Methods:From 2008 to 2015, the medical records of 728 subjects who underwent upper gastrointestinal endoscopy and sodium excretion in 24-hour urine tests were retrospectively reviewed. Sixty-six subjects were excluded due to diuretics use (n= 55), diagnosis with a gastric neoplasm (n= 4), or the cases of intestinal metaplasia in the absence of atrophy (n= 7), so 662 subjects were included. Atrophic gastritis and intestinal metaplasia were diagnosed by endoscopic findings. The subjects were grouped into three levels by tertiles of 24-hour urine sodium excretion.Results:A total of 192 (29.0%) had atrophic gastritis without intestinal metaplasia and 112 (16.9%) had atrophic gastritis with intestinal metaplasia. A total of 276 subjects (61.5%) were infected withHelicobacter pylori(H. pylori). In multivariate analyses,H. pyloriinfection [OR = 14.17; 95% confidence interval (CI), 7.12-28.22) was associated with atrophic gastritis without intestinal metaplasia. Highest levels of sodium excretion (OR = 2.870; 95% CI, 1.34-6.14), heavy smoking (≥20 pack-years) (OR = 2.75; 95% CI, 1.02-7.39), andH. pyloriinfection (OR = 3.96; 95% CI, 2.02-7.76) were associated with atrophic gastritis with intestinal metaplasia.Conclusions:Our endoscopy-based study suggested that high salt intake could be associated with an increased risk of atrophic gastritis with intestinal metaplasia.Impact:Low salt diet might be helpful to prevent gastric carcinogenesis.Cancer Epidemiol Biomarkers Prev; 26(7); 1133-8. ©2017 AACR.
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Ji Hyun
JH
Song
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Young Sun
YS
Kim
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Nam Ju
NJ
Heo
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Joo Hyun
JH
Lim
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea. youngsun@snuh.org.
Sun Young
SY
Yang
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
Goh Eun
GE
Chung
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.|Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Joo Sung
JS
Kim
D000328:Adult; D000368:Aged; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D005757:Gastritis, Atrophic / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology; D008875:Middle Aged; D065667:Renal Elimination; D012189:Retrospective Studies; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000009:adverse effects* / Q000652:urine; D013274:Stomach Neoplasms / Q000517:prevention & control*; D016482:Urinalysis / Q000379:methods
D017673:Sodium Chloride, Dietary