Lunet Nuno, Peleteiro Bárbara, Bastos Joana, Correia Sofia, Marinho Ana, Guimarães João T, La Vecchia Carlo, Barros Henrique
aInstitute of Public Health, University of Porto (ISPUP) Departments of bClinical Epidemiology, Predictive Medicine and Public Health cBiochemistry, University of Porto Medical School dDepartment of Clinical Pathology, São João Hospital Center, Porto, Portugal eDepartment of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri fDepartment of Medical Sciences and Public Health, University of Milan, Milan, Italy.
Eur J Cancer Prev. 2014 May;23(3):193-8. doi: 10.1097/CEJ.0b013e328364742a.
Helicobacter pylori infection is the most important risk factor for gastric cancer. It is acquired predominantly during childhood, and understanding the determinants of infection in early life may translate into identifying preventive measures. However, the independent role of child day-care attendance remains to be understood. The aim of the study was to evaluate the association between child day-care attendance and H. pylori infection in early life. The study was nested within Geração XXI, a birth cohort assembled in Portugal. Serum anti-H. pylori IgG was quantified using ELISA in 1047 children between the ages of 4 and 5 years, and information on child day-care attendance since birth was collected. Odds ratios and 95% confidence intervals (95% CIs), adjusted for the child's age and number of siblings, as well as maternal education and infection status, were computed using unconditional logistic regression. The prevalence of H. pylori infection was 30.6% (95% CI 27.9-33.6), and it increased significantly with the cumulative time of attendance in day-care centers/homes (from 13.2% among never attendees to 40.2% among those attending for >36 months; P for trend<0.001). The odds ratio was 4.88 (95% CI 2.55-9.35) among those attending these institutions for more than 3 years, in comparison with never attendees. H. pylori infection remains a frequent and early event in Portugal. Child day-care attendance increases the risk of infection, making this setting a target for preventive measures.
幽门螺杆菌感染是胃癌最重要的危险因素。该感染主要在儿童时期获得，了解生命早期感染的决定因素可能有助于确定预防措施。然而，儿童日托机构的独立作用仍有待了解。本研究的目的是评估儿童日托机构与生命早期幽门螺杆菌感染之间的关联。该研究嵌套于葡萄牙组建的“二十一世纪队列研究”（Geração XXI）中。采用酶联免疫吸附测定法（ELISA）对1047名4至5岁儿童的血清抗幽门螺杆菌IgG进行定量，并收集自出生以来儿童日托机构的相关信息。使用无条件逻辑回归计算比值比和95%置信区间（95%CI），并对儿童年龄、兄弟姐妹数量、母亲教育程度和感染状况进行了校正。幽门螺杆菌感染的患病率为30.6%（95%CI 27.9 - 33.6），且随着在日托中心/家庭的累计时间显著增加（从未参加者中为13.2%，参加超过36个月者中为40.2%；趋势P<0.001）。与从未参加者相比，在这些机构中参加超过3年的儿童，其比值比为4.88（95%CI 2.55 - 9.35）。在葡萄牙，幽门螺杆菌感染仍然是一种常见且早期发生的情况。儿童日托机构增加了感染风险，使这一环境成为预防措施的目标。
