Age, smoking and overweight contribute to the development of intestinal metaplasia of the cardia

Table 1 Characteristics of the cohort study group n (%)

	Total	Men	Women	P value	OR (95% CI)
No. of patients (%)	217	97 (45)	120 (55)
Age (yr)	45.3 ± 15.3	49.9 ± 16.5	43.3 ± 13.5
Reason for endoscopy1
Epigastric pain	62 (29)	31	31	NS
Barrett’s esophagus	26 (12)	20	6	0.01	4.94 (1.9-12.8)
Reflux grade 1	17 (8)	6	11	NS
Reflux grade 2	141 (65)	69	72	NS
Dyspepsia	9 (4)	3	6	NS
Dysphagia	2 (1)	2	0	NS
Gastric bypass	48 (22)	7	41	0.01	0.15 (0.06-0.35)
Anemia	5 (2)	2	3	NS
Celiac disease suspicion	7 (3)	4	3	NS
Ulcer follow-up	8 (4)	6	2	NS
Helicobacter antibiogram	4 (2)	1	3	NS
Personal history of reflux	141 (65)	69	72	NS
Tobacco use
Non smoker	119 (55)	46	73	NS
Past smoker	11 (5)	5	6	NS
Current smoker all	87 (40)	46	41	NS
Current smoker 0.5 p/d	48 (22)	27	21	NS
Current smoker > 1.0 p/d	39 (18)	19	20	NS
BMI	29.8 ± 10.6	32.4 ± 11.5	27.7 ± 7.7
PPI users	96 (44)	52	44	NS
NSAID users	37 (17)	20	17	NS

P value indicates results of the comparison of male and female patients.

¹Patients may have more than one pathology. OR: Odds ratio; BMI: Body mass index; PPI: Proton pump inhibitor; NSAID: Non steroidal antiinflammatory drug; NS: Not significant.

Table 2 Results of upper gastrointestinal endoscopy n (%)

	Total	Men	Women	P value
No. of patients	217	97	120
Normal	79 (36)	43	36	NS
Esophagitis1	26 (12)	14	12	NS
Hiatus hernia1	60 (28)	36	24	NS
Short segment Barrett’s	9 (4)	6	3	NS
Long segment Barrett’s	19 (9)	11	8	NS
Esophageal tumor	4 (2)	3	1	NS
Gastric ulcer	4 (2)	3	1	NS
Gastric tumor	1 (0.5)	1	0	NS
Gastritis	9 (4)	5	4	NS
Duodenal ulcer	3 (1)	2	1	NS
Duodenal atrophy	2 (1)	1	1	NS
Other	1 (0.5)	1	0	NS
H. pylori
Positive	70 (32)	33	37	NS
Negative	147 (68)	64	83	NS

P value indicates results of the comparison of male and female patients.

¹Patients may have more than one pathology. NS: Not significant; H. pylori: Helicobacter pylori.

Table 3 Relationship between the presence of Helicobacter pylori and reflux, Barrett’s esophagus, hiatus hernia, tobacco, sex and body mass index n (%)

	Total	H. pylori negative	H. pylori positive	P value	OR (95% CI)
H. pylori	217	147	70
Reflux = 0	59 (27)	36 (61)	23 (39)	NS
Reflux = 1	17 (8)	11 (65)	6 (35)	NS
Reflux = 2	141 (65)	100 (71)	41 (29)	NS
Short segment Barrett’s	9 (4)	8 (89)	1 (11)	NS
Long segment Barrett’s	19 (9)	16 (84)	3 (16)	NS
Normal gastroesophageal junction	189 (87)	122 (65)	67 (45)	0.01	4.58 (1.33-15.73)
Hiatus hernia
Absent	157 (72)	100 (64)	57 (36)	0.04	2.06 (1.03-4.13)
Present	60 (28)	47 (78)	13 (22)	0.03	0.49 (0.24-0.98)
Tobacco
Non smoker	119 (55)	85 (71)	34 (29)	NS
Past smoker	11 (5)	9 (82)	2 (18)	NS
Current smoker (all)	87 (40)	53 (61)	36 (39)	0.03	1.88 (1.08-3.35)
Current smoker 0.5 p/d	48 (22)	26 (54)	22 (46)	0.03	5.2 (1.1-4.12)
Current smoker > 1.0 p/d	39 (18)	27 (69)	12 (31)	NS
Age
Mean age	45.3	46.57	42.78	0.06
Sex
Male	97 (45)	64 (66)	33 (34)	NS
Female	120 (55)	83 (69)	37 (31)	NS
Body Mass Index
Mean BMI	29.8	30.6	28.1	NS

P value indicates results of the comparison of H. pylori positive patients and H. pylori negative patients. OR: Odds ratio; BMI: Body mass index; NS: Not significant; H. pylori: Helicobacter pylori.

Table 4 Relationship between reflux and Barrett’s esophagus, hiatus hernia, tobacco use, sex, age and body mass index n (%)

	Total	Reflux			P value
		Grade 0	Grade 1	Grade 2
No. of patients	217	59	17	141
Short segment Barrett’s	9 (4)	1 (11)	0	8 (89)	0.010
Long segment Barrett’s	19 (9)	1 (5)	1 (5)	17 (90)	0.010
Normal gastroesophageal junction	189 (87)	59 (31)	16 (9)	114 (60)	0.002
Hiatus hernia
Absent	157 (72)	49 (31)	13 (8)	94 (61)	0.060
Present	60 (28)	10 (17)	4 (7)	46 (76)	NS
Tobacco
Non smoker	119 (55)	32 (27)	13 (11)	74 (62)	NS
Past smoker	11 (5)	1 (10)	1 (10)	9 (80)	NS
Current smoker all	87 (40)	26 (29)	11 (13)	51 (48)	NS
Current smoker 0.5 p/d	48 (22)	14 (29)	7 (15)	27 (56)	NS
Current smoker > 1.0 p/d	39 (18)	12 (30)	3 (8)	24 (62)	NS
Sex
Male	97 (45)	22 (23)	6 (6)	69 (71)	NS
Female	120 (55)	37 (31)	11 (9)	72 (60)	NS
Age
Mean age	45.3	42	45.2	46.8	0.080
Body Mass Index
Mean BMI	29.8	27.9	33.1	30.2	0.080

BMI: Body mass index; NS: Not significant.

Table 5 Factors associated with intestinal metaplasia of the cardia n (%)

	Total	Intestinal metaplasia		P value	OR (95% CI)
		Absent	Present
No. of patients (%)	217	125 (58)	92 (42)
Indications for endoscopy
GERD1	141 (65)	106 (75)	35 (25)	NS
Epigastric pain1	62 (29)	41 (66)	21 (34)	NS
Gastric bypass	48 (22)	30 (63)	18 (37)	NS
Results of endoscopy
Normal	79 (36)	41 (52)	38 (48)	NS
GERD	26 (12)	10 (38)	16 (62)	0.060
Hiatus hernia	60 (28)	26 (43)	34 (57)	NS
Barrett's esophagus	28 (13)	13 (46)	15 (54)	NS
Other	29 (13)	17 (59)	12 (41)	NS
H. pylori
Positive	70 (32)	34 (49)	36 (51)
Negative	147 (68)	91 (62)	56 (28)	0.060
Reflux = 0	59 (27)	33 (56)	26 (44)
Reflux = 1	17 (8)	15 (88)	2 (12)
Reflux = 22	141 (65)	77 (55)	64 (45)	0.060
BMI	29.8 ± 10.6	31.61	27.33
Age	45.3 ± 15.3	43.29	50.68
Sex
Male	97 (45)	55 (57)	42 (43)	NS
Female	120 (55)	70 (58)	50 (42)	NS
Tobacco use
Non smoker	119	89	30
Past smoker	11	8	3	0.500	0.6 (0.13-1.9)
Current smoker all	87	28	59	0.001	6.19 (3.4-11.2)
Current smoker 0.5 p/d	48	14	32	0.001	4.23 (2.1-8.5)
Current smoker > 1.0 p/d	39	12	27	0.010	4.33 (2.1-9.1)
Antrum metaplasia	19	5	14	0.010	4.31 (1.49-12.4)
Fundus metaplasia	9	1	8	0.001	11.8 (1.45-96.1)

P value indicates results of the comparison of patients with or without intestinal metaplasia of the cardia.

¹patients may have more than one reason for endoscopy;

²data are missing. GERD: Gastroesophageal reflux disease; OR: Odds ratio; BMI: Body mass index; NS: Not significant; H. pylori: Helicobacter pylori.