Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
J Gastroenterol Hepatol. 2013 Nov;28(11):1705-11. doi: 10.1111/jgh.12315.
At the same time that Helicobacter pylori prevalence is declining in Western countries, immigrants from developing countries with high H. pylori prevalence have settled in Western urban areas. Actual epidemiological data on H. pylori in a migrant community may help in realizing a more selective approach to assess H. pylori-related diseases. We aimed to define H. pylori prevalence as well as risk groups for H. pylori in a cohort of young women living in a multi-ethnic European city.
We measured Immunoglobulin G (IgG) anti-H. pylori and CagA-antibodies in serum of pregnant women included in a population-based prospective cohort study, the Generation R study. Information on demographics and socioeconomic status was collected by questionnaires. Chi-square and logistic regression were used.
In total, 3146 (46%) of the 6837 tested women (mean age 29.7 ± 5.3) were H. pylori-positive and 1110 (35%) of them were CagA-positive. The H. pylori prevalence in Dutch women was 24%, which was significantly lower than in non-Dutch women (64%; P < 0.001). In particular, H. pylori positivity was found in 92% of Moroccan (odds ratio 19.2; 95% confidence interval 11.8-32.0), 80% of Cape Verdean (7.6; 5.0-11.5), 81% of Turkish (9.0; 6.7-12.1), 60% of Dutch Antillean (3.3; 2.3-4.7), and 58% of Surinamese women (3.0; 2.3-3.8). Among H. pylori-positive Dutch subjects, 19% were CagA-positive compared with 40% of the non-Dutch subjects (P < 0.001).
Despite a general trend of declining prevalence in Western countries, H. pylori remains highly prevalent in migrant communities, which may constitute target groups for screening and eradication to prevent H. pylori-related diseases.
在西方国家幽门螺杆菌(H. pylori)流行率下降的同时,来自发展中国家的移民也大量涌入西方国家的城市。对移民社区中 H. pylori 的实际流行病学数据的研究,可能有助于实现更有针对性的方法来评估与 H. pylori 相关的疾病。我们旨在确定生活在多民族欧洲城市的年轻女性群体中 H. pylori 的流行率以及 H. pylori 的高危人群。
我们在一项基于人群的前瞻性队列研究——“生育队列研究”中,测量了纳入研究的孕妇血清中的免疫球蛋白 G(IgG)抗 H. pylori 和 CagA 抗体。通过问卷调查收集人口统计学和社会经济地位信息。采用卡方检验和 logistic 回归进行分析。
在 6837 名接受检测的女性中,共有 3146 名(46%)为 H. pylori 阳性,1110 名(35%)为 CagA 阳性。荷兰女性的 H. pylori 流行率为 24%,显著低于非荷兰女性(64%;P < 0.001)。特别是,摩洛哥裔女性的 H. pylori 阳性率为 92%(优势比 19.2;95%置信区间 11.8-32.0),佛得角裔女性为 80%(7.6;5.0-11.5),土耳其裔女性为 81%(9.0;6.7-12.1),荷属安的列斯群岛裔女性为 60%(3.3;2.3-4.7),苏里南裔女性为 58%(3.0;2.3-3.8)。在 H. pylori 阳性的荷兰女性中,19%为 CagA 阳性,而非荷兰女性为 40%(P < 0.001)。
尽管西方国家的流行率呈普遍下降趋势,但 H. pylori 在移民群体中仍然高度流行,这些群体可能是筛查和根除 H. pylori 以预防与 H. pylori 相关疾病的目标人群。