Russo A, Maconi G, Spinelli P, Felice G D, Eboli M, Andreola S, Ravagnani F, Settesoldi D, Ferrari D, Lombardo C, Bertario L
Instituto Nazionale Tumori, Milan, Italy.
Am J Gastroenterol. 2001 May;96(5):1402-8. doi: 10.1111/j.1572-0241.2001.03773.x.
This study aimed to evaluate the influence of environmental and sociodemographic factors and the effect of smoking, alcohol, and dietary habits on the risk of gastric intestinal metaplasia (IM) in Helicobacter pylori-infected subjects.
The investigation was based on 2598 consecutive volunteer blood donors tested for the presence of antibodies against H. pylori from March 1995 to March 1997. Endoscopy with multiple biopsies was offered to all H. pylori-positive, symptomatic subjects. The presence or absence of IM was diagnosed by gastric biopsies. A serologically H. pylori-positive subject with gastric IM was defined as a case, whereas serologically H. pylori-positive subjects without IM were used as controls. All patients answered a detailed questionnaire collecting sociodemographic characteristics and smoking, alcohol drinking, and dietary habits. Odds ratios (ORs) and their 95% CIs were estimated by unconditional logistic regression, including terms for age and sex, to assess the association between the data collected and IM.
Three hundred forty-four subjects with serological H. pylori infection and upper-GI symptoms underwent GI endoscopy, during which biopsies were taken for histological diagnosis. Histology revealed metaplasia in 74 subjects (21.5%). Incomplete IM was found in 37.8% of these cases. No significant associations were found between IM and anthropometric or sociodemographic factors. There was a significant association between age and IM (chi2 for trend, 6.67; p value, 0.009). Current smokers of over 20 cigarettes per day had a 4-fold risk of IM (OR, 4.75, 95% CI, 1.33-16.99). A 2-fold increased risk was found for high butter consumers (OR, 2.17; 95% CI, 1.14-4.11). No significant specific associations were found between the variables studied and complete or incomplete IM.
This study found that smoking and high butter consumption may increase the risk of having gastric IM in H. pylori-positive subjects.
本研究旨在评估环境和社会人口统计学因素的影响，以及吸烟、饮酒和饮食习惯对幽门螺杆菌感染受试者发生胃肠化生（IM）风险的影响。
该调查基于1995年3月至1997年3月连续检测幽门螺杆菌抗体的2598名志愿献血者。对所有幽门螺杆菌阳性且有症状的受试者进行了多次活检的内镜检查。通过胃活检诊断是否存在IM。血清学检测幽门螺杆菌阳性且有胃IM的受试者被定义为病例，而血清学检测幽门螺杆菌阳性但无IM的受试者用作对照。所有患者都回答了一份详细问卷，收集社会人口统计学特征以及吸烟、饮酒和饮食习惯。通过无条件逻辑回归估计比值比（OR）及其95%置信区间，包括年龄和性别的项，以评估所收集数据与IM之间的关联。
344名血清学检测幽门螺杆菌感染且有上消化道症状的受试者接受了胃肠内镜检查，在此期间进行了活检以进行组织学诊断。组织学检查显示74名受试者（21.5%）有化生。这些病例中37.8%发现为不完全化生。未发现IM与人体测量或社会人口统计学因素之间存在显著关联。年龄与IM之间存在显著关联（趋势卡方值为6.67；p值为0.009）。每天吸烟超过20支的当前吸烟者发生IM的风险为4倍（OR为4.75，95%置信区间为1.33 - 16.99）。食用大量黄油者发生IM的风险增加2倍（OR为2.17；95%置信区间为1.14 - 4.11）。在所研究的变量与完全或不完全化生之间未发现显著的特定关联。
本研究发现，吸烟和大量食用黄油可能会增加幽门螺杆菌阳性受试者发生胃IM的风险。
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