TABLE 3.
Univariate and multivariate analysis for diagnosis of GIM with cumulative PPI exposure, stratified by Helicobacter pylori status
| Cohort | PPI quartiles (DDD) a | No GIM | GIM | Univariate | Multivariate (model 1) | Multivariate (model 2) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N (%) | N (%) | OR | 95% | CI | p value | Adj OR | 95% | CI | p value | Adj OR | 95% | CI | p value | ||
| H. pylori status: All | PPI‐Q1 | 3306 (92.7) | 260 (7.3) | 1.00 | (Ref) | 1.00 | (Ref) | 1.00 | (Ref) | ||||||
| PPI‐Q2 | 3373 (92.4) | 279 (7.6) | 1.05 | 0.88 | 1.24 | 0.573 | 1.10 | 0.92 | 1.32 | 0.284 | 1.12 | 0.94 | 1.33 | 0.206 | |
| PPI‐Q3 | 3093 (90.7) | 388 (9.3) | 1.27 | 1.08 | 1.50 | 0.004 | 1.27 | 1.07 | 1.52 | 0.007 | 1.26 | 1.06 | 1.49 | 0.010 | |
| PPI‐Q4 | 3131 (89.0) | 388 (11.0) | 1.60 | 1.37 | 1.88 | <0.001 | 1.32 | 1.11 | 1.57 | 0.002 | 1.32 | 1.11 | 1.57 | 0.001 | |
| Total | 12,903 (91.2) | 1244 (8.8) | P total | <0.001 | P total | 0.007 | P total | 0.008 | |||||||
| Trend | R 2: 0.94 | P trend | 0.006 | R 2: 0.90 | P trend | 0.013 | R2: 0.90 | P trend | 0.013 | ||||||
| H. pylori negative | PPI‐Q1 | 1935 (92.8) | 151 (7.2) | 1.00 | (Ref) | 1.00 | (Ref) | 1.00 | (Ref) | ||||||
| PPI‐Q2 | 2258 (92.5) | 184 (7.5) | 1.04 | 0.84 | 1.31 | 0.704 | 1.11 | 0.88 | 1.39 | 0.387 | 1.10 | 0.88 | 1.38 | 0.402 | |
| PPI‐Q3 | 2330 (91.1) | 227 (8.9) | 1.25 | 1.01 | 1.55 | 0.043 | 1.20 | 0.96 | 1.49 | 0.102 | 1.17 | 0.94 | 1.45 | 0.157 | |
| PPI‐Q4 | 2660 (89.6) | 310 (10.4) | 1.49 | 1.22 | 1.83 | 0.000 | 1.21 | 0.98 | 1.49 | 0.079 | 1.21 | 0.98 | 1.49 | 0.074 | |
| Total | 9183 (91.3) | 872 (8.7) | P total | <0.001 | P total | 0.288 | P total | 0.321 | |||||||
| Trend | R 2: 0.93 | P trend | 0.008 | R 2: 0.88 | P trend | 0.018 | R 2: 0.88 | P trend | 0.018 | ||||||
| H. pylori positive | PPI‐Q1 | 1371 (92.6) | 109 (7.4) | 1.00 | (Ref) | 1.00 | (Ref) | 1.00 | (Ref) | ||||||
| PPI‐Q2 | 1115 (92.1) | 95 (7.9) | 1.07 | 0.81 | 1.43 | 0.636 | 1.08 | 0.81 | 1.44 | 0.615 | 1.11 | 0.84 | 1.47 | 0.450 | |
| PPI‐Q3 | 763 (89.4) | 90 (10.6) | 1.48 | 1.11 | 1.99 | 0.008 | 1.40 | 1.04 | 1.89 | 0.026 | 1.39 | 1.04 | 1.85 | 0.028 | |
| PPI‐Q4 | 471 (85.8) | 78 (14.2) | 2.08 | 1.53 | 2.84 | <0.001 | 1.69 | 1.23 | 2.33 | 0.001 | 1.65 | 1.21 | 2.25 | 0.002 | |
| Total | 3720 (90.9) | 372 (9.1) | P total | <0.001 | P total | 0.004 | P total | 0.008 | |||||||
| Trend | R 2: 0.97 | P trend | 0.002 | R 2:0.95 | P trend | 0.005 | R 2: 0.95 | P trend | 0.005 | ||||||
| H. pylori positive and verified eradication | PPI‐Q1 | 444 (92.1) | 38 (7.9) | 1.00 | (Ref) | 1.00 | (Ref) | 1.00 | (Ref) | ||||||
| PPI‐Q2 | 312 (90.7) | 32 (9.3) | 1.20 | 0.73 | 1.96 | 0.471 | 1.20 | 0.73 | 1.97 | 0.477 | 1.22 | 0.74 | 2.03 | 0.432 | |
| PPI‐Q3 | 199 (86.5) | 31 (13.5) | 1.82 | 1.10 | 3.01 | 0.020 | 1.67 | 1.00 | 2.78 | 0.050 | 1.69 | 1.00 | 2.85 | 0.048 | |
| PPI‐Q4 | 128 (80.0) | 32 (20.0) | 2.92 | 1.76 | 4.86 | <0.001 | 2.43 | 1.44 | 4.11 | 0.001 | 2.21 | 1.29 | 3.81 | 0.004 | |
| Total | 1083 (89.1) | 133 (10.9) | P total | <0.001 | P total | 0.006 | P total | 0.023 | |||||||
| R 2: 0.98 | P trend | 0.001 | R 2: 0.98 | P trend | 0.001 | R 2: 0.98 | P trend | 0.001 | |||||||
Note: Model 1: age as a categorical variable; Model 2: age as a continuous variable; R 2:R square value of the regression model.
Abbreviations: CI, confidence interval; DDD, drug daily dose; GIM, gastric intestinal metaplasia; OR, odds ratio; PPI, proton pump inhibitor.
a
Ql–4: Quartiles of cumulative PPI dose in 10 years preceding index endoscopy.