Prevalence and determinants of serological evidence of atrophic gastritis among Arab and Jewish residents of Jerusalem: A cross-sectional study

Khitam Muhsen, Ronit Sinnreich, Dafna Merom, Gany Beer-Davidson, Hisham Nassar, Dani Cohen, Jeremy D. Kark

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Understanding the correlates of premalignant gastric lesions is essential for gastric cancer prevention. We examined the prevalence and correlates of serological evidence of atrophic gastritis, a premalignant gastric condition, using serum pepsinogens (PGs) in two populations with differing trends in gastric cancer incidence. Methods In a cross-sectional study, using ELISA we measured serum PGI and PGII concentrations (Biohit, Finland), Helicobacter pylori serum IgG and cytotoxin-associated gene A (CagA) antigen IgG antibodies in archived sera of 692 Jews and 952 Arabs aged 25-78 years, randomly selected from Israel's population registry in age-sex and population strata. Multivariable logistic regression analyses were performed. Results Using cut-offs of PGI <30μg/Lor PGI:PGII <3.0, the prevalence of atrophic gastritis was higher among Arab than Jewish participants: 8.8% (95% CIs 7.2% to 10.8%) vs 5.9% (95% CI 4.4% to 7.9%), increasing with age in both groups (p<0.001 for trend). Among Jewish participants, infection with H. pylori CagA phenotype was positively related to atrophic gastritis: adjusted OR (aOR) 2.16 (95% CI 0.94 to 4.97), but not to non-CagA infections aOR 1.17 (95% CI 0.53 to 2.55). The opposite was found among Arabs: aOR 0.09 (95% CI 0.03 to 0.24) for CagA positive and aOR 0.15 (95% CI 0.06 to 0.41) for Cag A negative phenotypes (p<0.001 for interaction). Women had a higher atrophic gastritis prevalence than men. Obesity and smoking were not significantly related to atrophic gastritis; physical activity tended to be inversely associated in Arabs (p=0.08 for interaction). Conclusions The prevalence of atrophic gastritis was higher among Arabs than Jews and was differently associated with the CagA phenotype.

Original languageEnglish
Article numbere024689
JournalBMJ Open
Volume9
Issue number1
DOIs
StatePublished - 1 Jan 2019

Keywords

  • epidemiology
  • gastroenterology
  • infectious diseases

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