Brief Article
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World J Gastroenterol. May 7, 2012; 18(17): 2076-2083
Published online May 7, 2012. doi: 10.3748/wjg.v18.i17.2076
Age, smoking and overweight contribute to the development of intestinal metaplasia of the cardia
Christian Felley, Hanifa Bouzourene, Marianne Bründler G VanMelle, Antoine Hadengue, Pierre Michetti, Gian Dorta, Laurent Spahr, Emiliano Giostra, Jean Louis Frossard
Christian Felley, Pierre Michetti, Gian Dorta, Service of Gastroenterology, University Hospital, 1000 Lausanne, Switzerland
Hanifa Bouzourene, Institute of Pathology, University Hospital, 1000 Lausanne, Switzerland
Marianne Bründler G VanMelle, Institute of Social and Preventive Medicine, University of Lausanne, 1000 Lausanne, Switzerland
Antoine Hadengue, Laurent Spahr, Emiliano Giostra, Jean Louis Frossard, Service of Gastroenterology, Geneva University Hospital, 1211 Geneva, Switzerland
Author contributions: Felley C, Hadengue A, Michetti P, Dorta G, Spahr L and Frossard JL conceived and designed the study, and acquired the data; Felley C, Bouzourene H, VanMelle MBG, Michetti P, Dorta G and Frossard JL analyzed and interpreted the data; Felley C, Hadengue A, Michetti P and Frossard JL drafted the manuscript; VanMelle MBG and Giostra E performed statistical analysis; Felley C, VanMelle MBG, Hadengue A and Frossard JL supervised the study.
Correspondence to: Jean Louis Frossard, MD, Service of Gastroenterology, Geneva University Hospital, 1211 Geneva, Switzerland. jean-louis.frossard@hcuge.ch
Telephone: + 41-22-3729340 Fax: +41-22-3729366
Received: June 9, 2011
Revised: January 4, 2012
Accepted: February 26, 2012
Published online: May 7, 2012
Abstract

AIM: To assess the role of Helicobacter pylori (H. pylori), gastroesophageal reflux disease (GERD), age, smoking and body weight on the development of intestinal metaplasia of the gastric cardia (IMC).

METHODS: Two hundred and seventeen patients scheduled for esophagogastroduodenoscopy were enrolled in this study. Endoscopic biopsies from the esophagus, gastroesophageal junction and stomach were evaluated for inflammation, the presence of H. pylori and intestinal metaplasia. The correlation of these factors with the presence of IMC was assessed using logistic regression.

RESULTS: IMC was observed in 42% of the patients. Patient age, smoking habit and body mass index (BMI) were found as potential contributors to IMC. The risk of developing IMC can be predicted in theory by combining these factors according to the following formula: Risk of IMC = a + s - 2B where a = 2,…6 decade of age, s = 0 for non-smokers or ex-smokers, 1 for < 10 cigarettes/d, 2 for > 10 cigarettes/d and B = 0 for BMI < 25 kg/m2 (BMI < 27 kg/m2 in females), 1 for BMI > 25 kg/m2 (BMI > 27 kg/m2 in females). Among potential factors associated with IMC, H. pylori had borderline significance (P = 0.07), while GERD showed no significance.

CONCLUSION: Age, smoking and BMI are potential factors associated with IMC, while H. pylori and GERD show no significant association. IMC can be predicted in theory by logistic regression analysis.

Keywords: Endoscopy, Gastroesophageal reflux disease, Metaplasia, Helicobacter pylori, Obesity, Smoking