Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Division on Clinical and Health Services Research, National Institute on Health and Health Disparities, Rockville, Maryland.
Clin Gastroenterol Hepatol. 2022 Mar;20(3):e438-e451. doi: 10.1016/j.cgh.2021.02.042. Epub 2021 Mar 2.
BACKGROUND & AIMS: Helicobacter pylori infection is the primary known risk factor for gastric cancer. Despite the global decline in H. pylori prevalence, this infection remains a major public health concern in developing areas, including Latin America. Our study aimed to determine H. pylori seroprevalence and identified its determinants among Hispanics/Latinos living in the United States (U.S.).
The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of self-identified Hispanics/Latinos (n = 16,144) in four U.S. communities, aged 18 to 74 years, recruited from randomly selected households using a stratified two-stage area probability sample design based on sampling households within sampled census block groups weighted for differential response rates. Anti-H. pylori immunoglobulin G antibodies were measured by an enzyme-linked immunosorbent assay using plasma samples. We calculated adjusted seroprevalence (i.e., predicted margins) from multivariable logistic regression models.
The overall weighted H. pylori seroprevalence was 57% among HCHS/SOL participants, with 38% and 62% seropositivity among U.S.-born and non-U.S.-born individuals, respectively. Age-adjusted prevalence varied by self-reported Hispanic/Latino background, ranging from 47% in Puerto Rican to 72% in Central American backgrounds. Adjusted H. pylori seroprevalence was higher in the following groups: older age, male sex, lower education, non-U.S. born status, smoking, greater number of missing teeth, fewer doctor visits, lower ferritin level, and hepatitis A seropositivity.
H. pylori seroprevalence in Hispanics/Latinos remains high and differed significantly by Hispanic/Latino background. H. pylori seropositivity is strongly associated with poor socioeconomic conditions. These findings highlight the ongoing importance of this bacterial infection in the U.S.
幽门螺杆菌感染是胃癌的主要已知危险因素。尽管全球范围内幽门螺杆菌的流行率有所下降，但在包括拉丁美洲在内的发展中地区，这种感染仍然是一个主要的公共卫生关注点。我们的研究旨在确定生活在美国的西班牙裔/拉丁裔人群中幽门螺杆菌的血清流行率，并确定其决定因素。
西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）是一项基于人群的自报西班牙裔/拉丁裔样本（n=16144 人），年龄在 18 至 74 岁之间，来自美国四个社区，采用基于抽样家庭的分层两阶段区域概率抽样设计，根据抽样的人口普查块组内的家庭进行抽样，对不同的回复率进行加权。使用酶联免疫吸附试验测定血浆样本中的抗幽门螺杆菌免疫球蛋白 G 抗体。我们使用多变量逻辑回归模型计算调整后的血清流行率（即预测边际）。
HCHS/SOL 参与者的总体加权幽门螺杆菌血清流行率为 57%，其中美国出生和非美国出生的个体分别为 38%和 62%呈阳性。经年龄调整后的患病率因自我报告的西班牙裔/拉丁裔背景而异，从波多黎各的 47%到中美洲背景的 72%不等。调整后的幽门螺杆菌血清流行率在以下人群中较高：年龄较大、男性、受教育程度较低、非美国出生、吸烟、缺失牙齿较多、就诊次数较少、铁蛋白水平较低和甲型肝炎血清阳性。
西班牙裔/拉丁裔人群中的幽门螺杆菌血清流行率仍然很高，且与西班牙裔/拉丁裔背景显著不同。幽门螺杆菌血清阳性与较差的社会经济条件密切相关。这些发现强调了这种细菌感染在美国仍然具有重要意义。
