Arai Junya, Fujiwara Hiroaki, Aoki Tomonori, Niikura Ryota, Ihara Sozaburo, Suzuki Nobumi, Hayakawa Yoku, Kasuga Masato, Fujishiro Mitsuhiro
Division of Gastroenterology, The Institute of Medical Science, Asahi Life Foundation, Tokyo 103-0002, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Clin Pract. 2024 May 8;14(3):779-788. doi: 10.3390/clinpract14030062.
Previous studies demonstrate an association between metabolic factors and -related gastric cancer. However, the association of gastric atrophy or intestinal metaplasia (IM) with these factors remains unknown.
Data on 1603 -positive patients who underwent esophagogastroduodenoscopy between 2001 and 2021 were evaluated. The outcome measures were endoscopic atrophy, IM grade, and the incidence of endoscopically diagnosed and pathologically confirmed gastric neoplasms. Clinical factors associated with these findings were also determined.
Advanced age; successful eradication; and comorbidities including diabetes mellitus (DM), hypertension, dyslipidemia, and fib4 index were significantly associated with endoscopic gastric atrophy grade. Male sex; advanced age; and comorbidities including DM, hypertension, dyslipidemia, hyperuricemia, fatty liver, aortic calcification, and fib4 index were also significantly associated with endoscopic IM grade, whereas advanced age, successful eradication, DM, fatty liver, and fib4 index were significantly associated with the incidence of gastric neoplasms.
Several metabolic disorders, including DM, hypertension, dyslipidemia, hyperuricemia, and fatty liver disease, are risk factors for advanced-grade gastric atrophy, intestinal metaplasia, and gastric neoplasms. Risk stratification according to these factors, particularly those with metabolic disorders, would affect EGD surveillance for -positive patients.
先前的研究表明代谢因素与相关胃癌之间存在关联。然而，胃萎缩或肠化生（IM）与这些因素之间的关联仍不清楚。
对2001年至2021年间接受食管胃十二指肠镜检查的1603例阳性患者的数据进行评估。观察指标为内镜下萎缩、IM分级以及内镜诊断和病理证实的胃肿瘤发生率。还确定了与这些结果相关的临床因素。
高龄；成功根除；以及合并症，包括糖尿病（DM）、高血压、血脂异常和fib4指数，与内镜下胃萎缩分级显著相关。男性；高龄；以及合并症，包括DM、高血压、血脂异常、高尿酸血症、脂肪肝、主动脉钙化和fib4指数，也与内镜下IM分级显著相关，而高龄、成功根除、DM、脂肪肝和fib4指数与胃肿瘤发生率显著相关。
包括DM、高血压、血脂异常、高尿酸血症和脂肪肝病在内的几种代谢紊乱是高级别胃萎缩、肠化生和胃肿瘤的危险因素。根据这些因素进行风险分层，特别是那些患有代谢紊乱的因素，将影响阳性患者的食管胃十二指肠镜监测。
