OBJECTIVE: Duodenal ulcer is regarded as the end result of alterations in which Helicobacter pylori (HP) plays a major role as a pathogenetic agent. The aim of this prospective study was to evaluate duodenal ulcer risk factors such as alcohol intake, smoking, use of non-steroidal anti-inflammatory drugs, age and sex in relation to HP colonization density. PATIENTS AND METHODS: 495 patients consecutively examined by diagnostic upper digestive endoscopy were assessed; none of them had had previous upper digestive endoscopy or peptic ulcer, recent anticulcer-antibiotic treatment, upper gastrointestinal surgery, or cancer. The HP colonization on antral bioptic specimens was graded semi-quantitatively as follows: HP--- (absence of HP); HP+--(focal presence of small amounts of HP); HP++- (intermediate situation between HP+-- and HP+++), and HP+++ (diffuse presence of large amounts of HP). RESULTS: Logistic regression analysis identified only male sex (odds ratio 1.88, p < 0.02), smoking more than 10 cigarettes/day (odds ratio 2.53, p < 0.01), and HP grade (HP +-- odds ratio 0.79, p = NS; HP++- odds ratio 2.42, p < 0.02; HP+++ odds ratio 3.66, p < 0.001) as independent risk factors of duodenal ulcer. CONCLUSION: The duodenal ulcer risk was found to correlate with HP density, male sex, and smoking, but not with non-steroidal anti-inflammatory drug use.
Antral mucosal Helicobacter pylori infection density as a risk factor of duodenal ulcer
ZAMBONI, Giuseppe;
1997-01-01
Abstract
OBJECTIVE: Duodenal ulcer is regarded as the end result of alterations in which Helicobacter pylori (HP) plays a major role as a pathogenetic agent. The aim of this prospective study was to evaluate duodenal ulcer risk factors such as alcohol intake, smoking, use of non-steroidal anti-inflammatory drugs, age and sex in relation to HP colonization density. PATIENTS AND METHODS: 495 patients consecutively examined by diagnostic upper digestive endoscopy were assessed; none of them had had previous upper digestive endoscopy or peptic ulcer, recent anticulcer-antibiotic treatment, upper gastrointestinal surgery, or cancer. The HP colonization on antral bioptic specimens was graded semi-quantitatively as follows: HP--- (absence of HP); HP+--(focal presence of small amounts of HP); HP++- (intermediate situation between HP+-- and HP+++), and HP+++ (diffuse presence of large amounts of HP). RESULTS: Logistic regression analysis identified only male sex (odds ratio 1.88, p < 0.02), smoking more than 10 cigarettes/day (odds ratio 2.53, p < 0.01), and HP grade (HP +-- odds ratio 0.79, p = NS; HP++- odds ratio 2.42, p < 0.02; HP+++ odds ratio 3.66, p < 0.001) as independent risk factors of duodenal ulcer. CONCLUSION: The duodenal ulcer risk was found to correlate with HP density, male sex, and smoking, but not with non-steroidal anti-inflammatory drug use.
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