Abstract
Since eradication of Helicobacter pylori (H. pylori) is thought to be a preventive measure against stomach cancer, several studies have examined factors associated with the infection. This paper reports the association of the infection with lifestyle factors observed in a hospital‐based case‐control study. Cases were 140 anti‐H. pylori IgG antibody‐positive outpatients (75 males and 65 females). Controls were 52 antibody‐negative outpatients (22 males and 30 females). Both groups had undergone gastroscopy at Aichi Cancer Center Hospital between February 1995 and February 1997, and lifestyle data collected on the first visit were linked to calculate odds ratios. A strong association was observed with smoking among males; age‐adjusted odds ratio (OR)=7.85, 95% confidence interval (CI), 2.03–30.4. Rice breakfast (OR=3.74; 95%CI, 1.30–10.8) and soybean paste soup (every day vs. occasionally, OR=5.24; 95%CI, 1.80–15.2) were also associated with antibody positivity in males, but not in females. In females, pickled Chinese cabbage (≥l/week vs. ≥3/month, OR=2.82; 95%CI, 1.06–7.48) and lettuce (≥ I/week vs. ≤3/month, OR=2.90; 95%CI, 1.09 7.76) were significantly associated with positivity. Multivariate analysis gave similar estimates for the above factors. Although the association between smoking and H. pylori infection has not been detected in past studies of a general population, except one recent one, this study on outpatients suggested a possible association. Smoking may work as a cofactor disturbing incidental eradication of H. pylori by antibacterial agents administered for other reasons.
Keywords: Case‐control study, Helicobacter pylori, Smoking
Full Text
The Full Text of this article is available as a PDF (355.9 KB).
REFERENCES
- 1. ) Dixon , M. F.Helicobacter pylori and peptic ulceration: histopathological aspects . J. Gastroenterol.Hepatol. , 6 , 125 – 130 ( 1991. ). [DOI] [PubMed] [Google Scholar]
- 2. ) Fukao , A. , Komatsu , S. , Tsubono , Y. , Hisamichi , S. , Ohori , H. , Kizawa , T. , Ohsato , N. , Fujino , N. , Endo , N. and Iha , M.Helicobacter pylori infection and chronic atrophic gastritis among Japanese blood donors: a crosssectional study . Cancer Causes Control , 4 , 307 – 312 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 3. ) Kuipers , E. J. , Uyterlinde , A. M. , Pena , A. S. , Roosendaal , R. , Pals , G. , Nelis , G. F. , Festen , H. P. M. and Meuwissen , S. G. MLong‐term sequelae of Helicobacter pylori gastritis . Lancet , 345 , 1525 – 1528 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 4. ) Kato , I. , Tominaga , S. , Ito , Y. , Kobayashi , S. , Yoshii , Y. , Matsuura , A. , Kameya , A. , Kano , T. and Ikari , A.A prospective study of atrophic gastritis and stomach cancer risk . Jpn. J. Cancer Res. , 83 , 1137 – 1142 ( 1992. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. ) Mapstone , N. P. , Lynch , D. A. , Lewis , F. A. , Axon , A. T. , Tompkins , D. S. , Dixon , M. F. and Quirke , P.PCR identification of Helicobacter pylori in faeces from gastritis patients . Lancet , 341 , 447 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Ferguson , D. A. , Jr. , Li , C. , Patel , N. R. , Mayberry , W. R. , Chi , D. S. and Thomas , E.Isolation of Helicobacter pylori from saliva . J. Clin. Microbiol. , 31 , 2802 – 2804 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7. ) Nguye , A. M. , Engstrand , L. , Genta , R. M. , Graham , D. Y. and El‐Zaatari , F. A.Detection of Helicobacter pylori in dental plaque by reverse transcription‐polymerase chain reaction . J. Clin. Microbiol , 31 , 783 – 787 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. ) Hulten , K. , Han , S. W. , Enroth , H. , Klein , P. D. , Opekun , A.R. , Oilman , R.H. , Evans , D. G‐ , Engstrand , L. , Graham , D. Y. and El‐zaatari , A. K.Helicobacter pylori in the drinking water in Peru . Gastroenterology , 110 , 1031 – 1035 ( 1996. ). [DOI] [PubMed] [Google Scholar]
- 9. ) Goodman , K. J. and Correa , P.The transmission of Helicobacter pylori. A critical review of the evidence . Int. J. Epidemiol. , 24 , 875 – 887 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 10. ) Tsugane , S. , Kabuto , M. , Imai , H. , Watanabe , S. and Sugano , K.Helicobacter pylori, dietary factors, and atrophic gastritis in five Japanese populations with different gastric cancer mortality . Cancer Causes Control , 4 , 297 – 305 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 11. ) Asaka , M. , Kimura , T. , Kubo , M. , Takeda , H. , Mitani , S. , Miyazaki , T. , Miki , K. and Graham , D. Y.Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population . Gastroenterology , 102 , 760 – 766 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 12. ) Inoue , M. , Tajima , K. , Hirose , K. , Hamajima , N. , Takezaki , T. , Kuroishi , T. and Tominaga , S.Epidemiological features of first‐visit outpatients in Japan: comparison with general population and variation by sex, age, and season . J. Clin. Epidemiol. , 50 , 69 – 77 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 13. ) Kosunen , T. U. , Seppala , K. , Sarna , S. and Sipponen , P.Diagnostic value of decreasing IgG, IgA, and IgM antibody titres after eradication of Helicobacter pylori . Lancet , 339 , 893 – 895 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 14. ) SAS Institute Inc. SAS/STAT user's guide, version 6 ( 1990. ). SAS Institute Inc. , Cary, North Carolina . [Google Scholar]
- 15. ) The EUROGAST Study Group . Epidemiology of, and risk factorsfor, Helicobacter pylori infectionamong2194 asymptomatic subjects in 17 populations . Gut , 34 , 1672 – 1676 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. ) Maxton , D. G. , Srivastava , E. D. , Whorwell , P. J. and Jones , D. M.Do non-steroidal anti-inflammatory drugs or smoking predispose to Helicobacterpylori infection? Postgrad. Med. J. , 66 , 717 – 719 ( 1990. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17. ) Tsugane , S. , Tei , Y. , Takahashi , T. , Watanabe , S. and Sugano , K.Salty food intake and risk of Helicobacter pylori infection . Jpn. J. Cancer Res. , 85 , 474 – 478 ( 1994. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18. ) Malaty , H. M. , Kim , J. G. and Graham , D. Y.Prevalence of Helicobacter pylori infection in Korean children: inverse relation to socioeconomic status despite a uniformly high prevalence in adults . Am. J. Epidemiol. , 143 , 257 – 262 ( 1996. ). [DOI] [PubMed] [Google Scholar]
- 19. ) Murray , L. J. , McCrum , E. E. , Evans , A. E. and Bamford , K. B.Epidemiologyof Helicobacter pylori infection among 4742 randomly selected subjects from Northern Ireland . Int. J. Epidemiol. , 26 , 880 – 887 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 20. ) Fontham , E. T. H. , Ruiz , B. , Perez , A. , Hunter , F. and Correa , P.Determinants of Helicobacter pylori infection and chronic gastritis . Am. J. Gastroenterol. , 90 , 1094 – 1101 ( 1995. ). [PubMed] [Google Scholar]
- 21. ) Bertoni , G. , Sassatelh , R. , Nigrisoli , E. , Tansini , P. , Bianchi , G. , Casa , G. D. , Bagni , A. and Bedogni , G.Triple therapy with azithromycin, omeprazole, and amoxicillin is highly effective in the eradication of Helicobacter pylori: a controlled trial versus omeprazole plus amoxicillin . Am. J. Gastroenterol. , 91 , 258 – 263 ( 1996. ). [PubMed] [Google Scholar]
- 22. ) Moayyedi , P. , Chalmers , D. M. and Axon , A. T.Patient factors that predict failure of omeprazole, clarithroraycin, and tinidazole to eradicate Helicobacter pylori . J. Gastroenterol. , 32 , 24 – 27 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 23. ) Parsonnet , J. , Blaser , M. J. , Perez‐Perez , G. I. , Hargrett‐Bean , N. and Tauxe , R. V.Symptoms and risk factors of Helicobacter pylori infection in a cohort of epidemiologists . Gastroenterology , 102 , 41 – 46 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 24. ) Craanen , M. E. , Blok , P. , Dekker , W. , Ferwerda , J. and Tytgat , G.N.Subtypes of intestinal metaplasia and Helicobacter pylori . Gut , 33 , 597 – 600 ( 1992. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25. ) Genta , R. M. , Graham , D. Y.Intestinal metaplasia, not atrophy or achlorhydria, creates a hostile environment for Helicobacter pylori . Scand. J. Gastroenterol. , 28 , 924 – 928 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 26. ) Craanen , M. E. , Blok , P. , Dekker , W. and Tytgat , G. N.Helicobacter pylori and early gastric cancer . Gut , 35 , 1372 – 1374 ( 1994. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27. ) Meyer‐Rosberg , K. , Scott , D. R. , Rex , D. , Melchers , K. and Sachs , G.The effect of environmental pH on the proton motive force of Helicobacter pylori . Gastroenterology , 111 , 886 – 900 ( 1996. ). [DOI] [PubMed] [Google Scholar]
- 28. ) Tajima , K. and Tominaga , S.Dietary habits and gastrointestinal cancers: a comparative case‐control study of stomach and large intestinal cancers in Nagoya, Japan . Jpn. J. Cancer Res. (Gann) , 76 , 705 – 716 ( 1985. ). [PubMed] [Google Scholar]
- 29. ) Nomura , A. M. Y. , Stemmermann , G. N. and Chyou , P.‐H.Gastric cancer among the Japanese in Hawaii . Jpn. J. Cancer Res. , 86 , 916 – 923 ( 1995. ). [DOI] [PMC free article] [PubMed] [Google Scholar]