Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas

doi:10.3748/wjg.v26.i37.5682

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Oct 7, 2020; 26(37): 5682-5692
Published online Oct 7, 2020. doi: 10.3748/wjg.v26.i37.5682

Table 1 Baseline characteristics of 6018 subjects

Parameter	Nonpolyp, n = 3983	Adenoma, n = 1012	Nonadenomatous polyp, n = 1023	Advanced adenoma, n = 143	^aP value	^bP value	^cP value
Male/female	2336/1647	780/232	788/235	110/33	< 0.001	< 0.001	< 0.001
HP (+/-)	1936/2047	536/476	509/514	78/65	0.013	0.512	0.165
AG (+/-)	347/3636	139/873	116/907	21/122	< 0.001	0.016	0.049
Smoker (+/-)	1029/2954	402/610	430/593	61/82	< 0.001	< 0.001	< 0.001
Alcohol (+/-)	1423/2560	494/518	476/547	68/75	< 0.001	< 0.001	0.006
Age in yr	46.430 (10.150)	52.680 (9.981)	50.010 (10.269)	53.310 (9.738)	< 0.001	< 0.001	< 0.001
BMI	23.611 (3.160)	24.355 (2.938)	24.667 (3.099)	24.809 (2.929)	< 0.001	< 0.001	< 0.001
SBP	123.950 (17.747)	129.700 (18.488)	127.810 (18.388)	131.650 (17.271)	< 0.001	< 0.001	< 0.001
DBP	73.410 (12.255)	76.990 (12.036)	75.910 (12.541)	77.520 (11.798)	< 0.001	< 0.001	< 0.001
TC	5.296 (1.076)	5.434 (1.155)	5.387 (1.077)	5.528 (1.083)	< 0.001	0.016	0.012
TG	1.771 (1.586)	1.982 (1.784)	2.001 (1.525)	2.194 (1.693)	< 0.001	< 0.001	0.002
HDL	1.296 (0.330)	1.252 (0.330)	1.216 (0.304)	1.237 (0.335)	< 0.001	< 0.001	0.034
LDL	3.169 (0.841)	3.253 (0.866)	3.258 (0.855)	3.259 (0.905)	0.005	0.003	0.208
FBG	4.818 (1.136)	5.065 (1.422)	5.055 (1.395)	5.091 (1.608)	< 0.001	< 0.001	0.047

^aTwo-sided P values for the difference between adenoma and nonpolyp were based on the χ² test and t test.

^bTwo-sided P values for the difference between nonadenomatous polyp and nonpolyp were based on the χ² test and t test.

^cTwo-sided P values for the difference between advanced adenoma and nonpolyp were based on the χ² test and t test. HP: Helicobacter pylori; AG: Atrophic gastritis; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; TC: Total cholesterol; TG: Triglyceride; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; FBG: Fasting blood glucose.

Table 2 Correlation between Helicobacter pylori infection and colorectal neoplasm

Parameter	HP (-), n = 3037	HP (+), n = 2981	OR (95%CI)	P value
Age in yr	48.130 (10.678)	48.040 (10.177)	0.999 (0.994-1.004)	0.745
Female	1026	1088	1
Male	2011	1893	0.888 (0.798-0.987)	0.027
Nonpolyp	2047	1936	1
Nonadenomatous polyp	514	509	1.047 (0.913-1.201)	0.512
Adenoma	476	536	1.191 (1.037-1.367)	0.013
Advanced adenoma	65	78	1.269 (0.908-1.774)	0.164
Villous adenoma	24	23	1.013 (0.570-1.801)	0.964
Size of adenoma ≥ 10 mm	49	64	1.381 (0.947-2.014)	0.093
High-grade dysplasia	5	8	1.692 (0.552-5.180)	0.357
Polyps number
One	509	521	1.082 (0.944-1.241)	0.258
Two or more	481	524	1.152 (1.003-1.323)	0.045
Polyps size
0-9 mm	925	963	1.101 (0.987-1.228)	0.086
≥ 10 mm	65	82	1.334 (0.958-1.858)	0.088

Correlation between Helicobacter pylori (+) and Helicobacter pylori (-) by logistic regression analysis. OR: Odds ratio; CI: Confidence interval; HP: Helicobacter pylori.

Table 3 Logistic regression model of the association between Helicobacter pylori infection, atrophic gastritis and colorectal neoplasm after adjustments for confounding factors

	Nonadenomatous polyp		Adenoma		Advanced adenoma
	Adjusted OR (95%CI)	P value	Adjusted OR (95%CI)	P value	Adjusted OR (95%CI)	P value
HP (+)	1.033 (0.895-1.193)	0.658	1.220 (1.053-1.413)	0.008	1.303 (0.922-1.842)	0.134
AG (+)	1.103 (0.872-1.394)	0.413	1.237 (0.988-1.549)	0.064	1.320 (0.805-2.165)	0.271

Adjusted for age, gender, systolic blood pressure, diastolic blood pressure, body mass index, smoking habit, alcohol consumption, total cholesterol level, triglyceride level, high-density lipoprotein-C level, low-density lipoprotein-C level and fasting blood glucose level by logistic regression analysis. HP: Helicobacter pylori; AG: Atrophic gastritis; OR: Odds ratio; CI: Confidence interval.

Table 4 Correlation between atrophic gastritis and colorectal neoplasm

Parameter	AG (-), n = 5416	AG (+), n = 602	OR (95%CI)	P value
Age in yr	47.590 (10.350)	52.530 (10.117)	1.045 (1.037-1.053)	< 0.001
Female	1921	193	1
Male	3495	409	1.165 (0.973-1.394)	0.097
Nonpolyp	3636	347	1
Nonadenomatous polyp	907	116	1.340 (1.073-1.674)	0.010
Adenoma	873	139	1.668 (1.352-2.059)	< 0.001
Advanced adenoma	122	21	1.804 (1.121-2.903)	0.015
Villous adenoma	40	7	1.834 (0.815-4.124)	0.143
Size of adenoma ≥ 10 mm	98	15	1.604 (0.921-2.792)	0.095
High-grade dysplasia	12	1	0.873 (0.113-6.735)	0.897
Polyps number
One	893	137	1.608 (1.302-1.985)	< 0.001
Two or more	887	118	1.394 (1.117-1.739)	0.003
Polyps size
0-9 mm	1649	239	1.519 (1.275-1.809)	< 0.001
≥ 10 mm	131	16	1.280 (0.753-2.176)	0.362

Correlation between atrophic gastritis (+) and atrophic gastritis (-) by logistic regression analysis. OR: Odds ratio; CI: Confidence interval; AG: Atrophic gastritis.

Table 5 Association between Helicobacter pylori infection, atrophic gastritis and colorectal neoplasm

	HP (–) AG (–), n = 2758		HP (–) AG (+), n = 279			HP (+) AG (–), n = 2658			HP (+) AG (+), n = 323
	n (%)	OR (95%CI)	n (%)	OR (95%CI)	P value	n (%)	OR (95%CI)	P	n (%)	OR (95%CI)	P
Age in yr, mean ± SD	47.7 ± 10.6		52.8 ± 10.5			47.5 ± 10.1			52.3 ± 9.8
Male sex	1818 (65.9)		193 (69.2)			1677 (63.1)			216 (66.9)
Nonadenomatous polyp	460 (16.7)	1	54 (19.4)	1.339 (0.969-1.851)	0.077	447 (16.8)	1.043 (0.901-1.206)	0.574	62 (19.2)	1.394 (1.027-1.892)	0.033
Adenoma	416 (15.1)	1	60 (21.5)	1.645 (1.202-2.252)	0.002	457 (17.2)	1.179 (1.017-1.367)	0.029	79 (24.5)	1.964 (1.477-2.610)	< 0.001
Advanced adenoma	58 (2.1)	1	7 (2.5)	1.377 (0.618-3.064)	0.434	64 (2.4)	1.184 (0.825-1.699)	0.360	14 (4.3)	2.496 (1.366-4.562)	0.003

Univariate logistic regression was used to analyze the association between Helicobacter pylori infection, atrophic gastritis and colorectal neoplasm. HP: Helicobacter pylori; AG: Atrophic gastritis; OR: Odds ratio; CI: Confidence interval; SD: Standard deviation.

Table 6 Logistic regression model of the association between Helicobacter pylori infection, atrophic gastritis and colorectal neoplasm after adjustments for confounding factors

	HP (–) AG (–), n = 2758	HP (–) AG (+), n = 279		HP (+) AG (–), n = 2658		HP (+) AG (+), n = 323
	OR (95%CI)	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Non-adenomatous polyp	1	1.093 (0.776-1.540)	0.612	1.03 (0.884-1.199)	0.707	1.141 (0.830-1.568)	0.417
Adenoma	1	1.216 (0.868-1.705)	0.255	1.213 (1.037-1.419)	0.016	1.491 (1.103-2.015)	0.009
Advanced adenoma	1	0.979 (0.431-2.226)	0.960	1.214 (0.836-1.763)	0.308	1.910 (1.022-3.572)	0.043

Citation: Chen QF, Zhou XD, Fang DH, Zhang EG, Lin CJ, Feng XZ, Wang N, Wu JS, Wang D, Lin WH. Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas. World J Gastroenterol 2020; 26(37): 5682-5692
URL: https://www.wjgnet.com/1007-9327/full/v26/i37/5682.htm
DOI: https://dx.doi.org/10.3748/wjg.v26.i37.5682