Wang Chaochen, Nishiyama Takeshi, Kikuchi Shogo, Inoue Manami, Sawada Norie, Tsugane Shoichiro, Lin Yingsong
Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Sci Rep. 2017 Nov 14;7(1):15491. doi: 10.1038/s41598-017-15490-7.
Changing trends in the prevalence of H. pylori infection in the general population over time are thought to be the main driving force behind the declining gastric cancer mortality in Japan. However, whether the prevalence of H. pylori infection itself shows a birth-cohort pattern needs to be corroborated. We performed a systematic review of studies that reported the prevalence of H. pylori infection among Japanese individuals. Meta-regression was conducted in the framework of a generalized additive mixed model (GAMM) to account for heterogeneity in the prevalence of H. pylori infection as a function of birth year. The prevalence of H. pylori infection confirmed a clear birth cohort pattern: the predicted prevalence (%, 95% CI) was 60.9 (56.3-65.4), 65.9 (63.9-67.9), 67.4 (66.0-68.7), 64.1 (63.1-65.1), 59.1 (58.2-60.0), 49.1 (49.0-49.2), 34.9 (34.0-35.8), 24.6 (23.5-25.8), 15.6 (14.0-17.3), and 6.6 (4.8-8.9) among those who were born in the year 1910, 1920, 1930, 1940, 1950, 1960, 1970, 1980, 1990, and 2000, respectively. The present study demonstrated a clear birth-cohort pattern of H. pylori infection in the Japanese population. The decreased prevalence of H. pylori infection in successive generations should be weighed in future gastric cancer control programs.
随着时间推移，普通人群中幽门螺杆菌感染率的变化趋势被认为是日本胃癌死亡率下降的主要驱动力。然而，幽门螺杆菌感染率本身是否呈现出生队列模式仍需进一步证实。我们对报告日本人群中幽门螺杆菌感染率的研究进行了系统综述。在广义相加混合模型（GAMM）框架内进行元回归，以解释幽门螺杆菌感染率作为出生年份函数的异质性。幽门螺杆菌感染率呈现出明显的出生队列模式：分别出生于1910年、1920年、1930年、1940年、1950年、1960年、1970年、1980年、1990年和2000年的人群中，预测感染率（%，95%CI）分别为60.9（56.3 - 65.4）、65.9（63.9 - 67.9）、67.4（66.0 - 68.7）、64.1（63.1 - 65.1）、59.1（58.2 - 60.0）、49.1（49.0 - 49.2）、34.9（34.0 - 35.8）、24.6（23.5 - 25.8）、15.6（14.0 - 17.3）和6.6（4.8 - 8.9）。本研究证明了日本人群中幽门螺杆菌感染存在明显的出生队列模式。在未来的胃癌控制计划中，应考虑到连续几代人中幽门螺杆菌感染率下降的因素。
