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Demographic and Lifestyle Risk Factors for Gastric Intestinal Metaplasia Among US Veterans
The American Journal of Gastroenterology ( IF 8.0 ) Pub Date : 2020-03-01 , DOI: 10.14309/ajg.0000000000000498
Mimi C Tan 1 , Niharika Mallepally 2 , Yan Liu 1, 3 , Hashem B El-Serag 2, 3 , Aaron P Thrift 4, 5
Affiliation  

OBJECTIVES The risk of noncardia gastric cancer is increased in the presence of gastric intestinal metaplasia. We aimed to identify demographic and lifestyle factors independently associated with the risk of gastric intestinal metaplasia. METHODS We used data from a cross-sectional study of patients attending primary care and endoscopy clinics at the Michael E. DeBakey VA Medical Center in Houston, Texas, between February 2008 and August 2013. All patients completed standardized questionnaires and underwent endoscopy with gastric mapping biopsies. Gastric intestinal metaplasia cases included patients with intestinal metaplasia on any noncardia gastric biopsy; we defined extensive gastric intestinal metaplasia as antrum and corpus involvement. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate logistic regression models. RESULTS We identified 423 cases with gastric intestinal metaplasia and 1,796 controls without gastric intestinal metaplasia. Older age (vs <60 years: 60-69 years AdjOR, 1.50; 95% CI, 1.17-1.93; ≥70 years AdjOR, 2.12; 95% CI, 1.48-3.04), male sex (AdjOR, 2.76; 95% CI, 1.50-5.10), nonwhite race/ethnicity (vs non-Hispanic white: Hispanic, AdjOR, 2.66; 95% CI, 1.89-3.76; black, AdjOR, 2.36; 95% CI, 1.85-3.02), and current smoking status (AdjOR, 1.78; 95% CI, 1.29-2.48) were independently associated with gastric intestinal metaplasia. These risk factors remained statistically significantly associated with gastric intestinal metaplasia after adjusting for Helicobacter pylori infection, and their effect sizes were larger for associations with extensive gastric intestinal metaplasia compared with focal gastric intestinal metaplasia. DISCUSSION Older age, male sex, nonwhite race/ethnicity, and current smoking status were the nonendoscopic factors independently associated with gastric intestinal metaplasia in a predominantly nonimmigrant US population.

中文翻译:

美国退伍军人胃肠化生的人口统计学和生活方式危险因素

目的 存在胃肠化生时,非贲门胃癌的风险会增加。我们旨在确定与胃肠化生风险独立相关的人口统计学和生活方式因素。方法 我们使用了 2008 年 2 月至 2013 年 8 月期间在德克萨斯州休斯顿 Michael E. DeBakey VA 医疗中心初级保健和内窥镜诊所就诊的患者的横断面研究数据。所有患者都完成了标准化问卷并接受了胃测绘的内窥镜检查活组织检查。胃肠化生病例包括在任何非贲门胃活检中出现肠化生的患者;我们将广泛的胃肠化生定义为胃窦和胃体受累。我们使用多元逻辑回归模型估计了优势比 (OR) 和 95% 置信区间 (CI)。结果 我们确定了 423 例有胃肠化生的病例和 1,796 例无胃肠化生的对照。年龄较大(与 <60 岁相比:60-69 岁 AdjOR,1.50;95% CI,1.17-1.93;≥70 岁 AdjOR,2.12;95% CI,1.48-3.04),男性(AdjOR,2.76;95% CI) , 1.50-5.10)、非白人种族/族裔(与非西班牙裔白人相比:西班牙裔,AdjOR,2.66;95% CI,1.89-3.76;黑人,AdjOR,2.36;95% CI,1.85-3.02)和当前吸烟状况(AdjOR, 1.78; 95% CI, 1.29-2.48) 与胃肠化生独立相关。在调整幽门螺杆菌感染后,这些危险因素与胃肠化生在统计学上仍显着相关,与局灶性胃肠化生相比,它们对广泛性胃化生的影响更大。讨论 在以非移民为主的美国人群中,年龄较大、男性、非白人种族/民族和当前吸烟状况是与胃肠化生独立相关的非内窥镜因素。
更新日期:2020-03-01
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