Family history is an independent risk factor for the progression of gastric atrophy among patients with Helicobacter pylori infection

Toshihiro Nishizawa; Hidekazu Suzuki; Kosuke Sakitani; Hiroharu Yamashita; Shuntaro Yoshida; Keisuke Hata; Takamitsu Kanazawa; Naoto Fujiwara; Takanori Kanai; Naohisa Yahagi; Osamu Toyoshima

doi:10.1177/2050640616642341

Family history is an independent risk factor for the progression of gastric atrophy among patients with Helicobacter pylori infection

United European Gastroenterol J. 2017 Feb;5(1):32-36. doi: 10.1177/2050640616642341. Epub 2016 Jun 22.

Authors

Affiliations

¹ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan; Division of Gastroenterology and Hepatology, Department Of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
² Medical Education Center, Keio University School of Medicine, Tokyo, Japan.
³ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Division of Gastroenterology, The Institute for Adult Disease, Asahi Life Foundation, Tokyo, Japan.
⁴ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Department of Gastrointestinal Surgery, The University of Tokyo, Tokyo, Japan.
⁵ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
⁷ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan; Department of Surgery, The Fraternity Memorial Hospital, Tokyo, Japan.
⁸ Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁹ Division of Gastroenterology and Hepatology, Department Of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
¹⁰ Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.
¹¹ Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.

Abstract

Background and aim: Risk factors for progression of gastric atrophy have not been fully elucidated. The aim of this study was to evaluate the risk factors for the development of atrophic gastritis in patients with Helicobacter pylori (H. pylori ) infection.

Methods: We reviewed 206 H. pylori-infected patients retrospectively. Endoscopic gastric atrophy was classified into closed- and open-type. We conducted univariate and multivariate logistic regression analyses on the contribution of age, sex, body mass index, past history of cancer, the first-degree family history of gastric cancer, habitual smoking and alcohol drinking, and endoscopic findings of gastric ulcer or duodenal ulcer for open-type gastric atrophy.

Results: On multivariate analysis, age (odds ratio = 1.079, 95% confidence interval = 1.048-1.11, p < 0.001), family history of gastric cancer (odds ratio = 3.967, 95% confidence interval = 1.414-10.6, p = 0.006) and duodenal ulcer (odds ratio = 0.834, 95% confidence interval = 0.711-0.977, p = 0.024) were the factors independently associated with open-type gastric atrophy.

Conclusions: A first-degree family history of gastric cancer, absence of duodenal ulcer, and old age were independent risk factors for the progression of gastric atrophy among H. pylori-infected patients. Careful examination with upper gastrointestinal endoscopy is necessary in patients with such risk factors.

Keywords: Atrophic gastritis; H. pylori; duodenal ulcer; family history; gastric cancer.