Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Table 1 Patient characteristics and their associations with gastric intestinal metaplasia

	Gastric IM (+)	Gastric IM (-)	Univariate analysis	Multivariate analysis
	n = 468	n = 171		[OR (95%CI)]
Age (mean/median, yr)	61.0/64.0	48.8/53.0	P < 0.001	--
Male sex	208 (44.4%)	77 (45.0%)	P = 0.928	--
Family history of gastric cancer	23 (5.7%)1	5 (2.9%)	P = 0.557	1.38 (0.52, 4.25), P = 0.555
Tobacco use	214 (48.6%)2	61 (36.5%)3	P = 0.007	1.73 (1.18, 2.55), P = 0.005
Alcohol use	100 (22.7%)2	46 (26.9%)	P = 0.219	0.76 (0.50, 1.16), P = 0.199
H2-blocker use	21 (5.1%)4	13 (7.6%)	P = 0.251	0.74 (0.35, 1.59), P = 0.426
PPI use	258 (62.6%)4	94 (55.6%)	P = 0.088	1.23 (0.84, 1.79), P = 0.282
Medicare	245 (52.4%)	46 (26.9%)	P < 0.001	1.94 (1.20, 3.17), P = 0.007
Medicaid	24 (5.1%)	27 (15.8%)	P = 0.003	0.57 (0.30, 1.09), P = 0.090
Private insurance	118 (25.2%)	72 (42.1%)	P < 0.001	0.66 (0.44, 0.99), P = 0.047
Uninsured	68 (14.5%)	32 (18.7%)	P = 0.885	1.04 (0.64, 1.71), P = 0.885

¹Information about family history was missing from 65 patients who had gastric intestinal metaplasia;

²Information about social history was missing from 28 patients who had gastric intestinal metaplasia;

³Information about tobacco use was missing from 4 patients who did not have gastric intestinal metaplasia;

⁴Information about H2-blocker and/or PPI use was missing from 56 patients who had gastric intestinal metaplasia. IM: Intestinal metaplasia; PPI: Proton-pump inhibitor.

Table 2 Association among indications and gastric intestinal metaplasia

	Frequency in patients with gastric IM1	Frequency in patients without gastric IM1	Univariate analysis	Multivariate analysis
				[OR (95%CI)]
Abdominal pain	188 (41.7%)	93 (54.4%)	P = 0.005	0.81 (0.55, 1.18), P = 0.267
Weight loss	63 (13.5%)	21 (7.4%)	P = 0.014	1.81 (0.95, 3.66), P = 0.073
GI bleed	38 (8.4%)	13 (7.6%)	P = 0.755	1.23 (0.63, 2.52), P = 0.558
Nausea	60 (13.3%)	27 (15.8%)	P = 0.426	0.97 (0.58, 1.65), P = 0.903
Dysphagia	59 (13.1%)	26 (15.2%)	P = 0.490	0.74 (0.44, 1.26), P = 0.259
Barrett’s esophagus	10 (2.2%)	8 (4.7%)	P = 0.123	0.32 (0.12, 0.92), P = 0.034

¹The denominator (n) used to calculate the percentage of patients by indication (in each row) may vary depending on what was available from the clinical records. IM: Intestinal metaplasia; GI: Gastrointestinal.

Table 3 Associations among endoscopic findings (prior to or without histopathology) and gastric intestinal metaplasia

	Frequency in patients with gastric IM, n = 418	Frequency in patients without gastric IM, n = 171	Univariate analysis	Multivariate analysis (OR, 95%CI)
Gastritis	100 (23.9%)	37 (21.6%)	P = 0.557	1.34 (0.84, 2.08), P = 0.223
Atrophic gastritis	55 (13.2%)	9 (5.3%)	P = 0.004	2.05 (1.00, 4.58), P = 0.051
Gastric mass	20 (4.8%)	0 (0%)	P = 0.001	8.84 (1.88, ∞), P = 0.005
Gastric ulcer	42 (10.0%)	11 (6.4%)	P = 0.163	1.42 (0.71, 3.01), P = 0.339
Gastric nodularity	71 (17.0%)	33 (19.3%)	P = 0.503	0.74 (0.46, 1.20), P = 0.213
Linitis plastica	1 (0.2%)	0 (0%)	P = 0.710	0.27 (0.01, ∞), P = 0.788
Esophagitis	28 (6.7%)	23 (13.4%)	P = 0.011	0.49 (0.26, 0.91), P = 0.023
Esophageal mass	2 (0.5%)	13 (7.6%)	P < 0.001	0.04 (0.01-0.16), P < 0.001
Barrett’s esophagus	21 (5.0%)	13 (7.6%)	P = 0.235	0.56 (0.26, 1.21), P = 0.134
Duodenitis	17 (4.1%)	11 (6.4%)	P = 0.234	0.69 (0.30, 1.60), P = 0.337
Duodenal polyp	8 (1.9%)	0 (0%)	P = 0.063	4.21 (0.81, ∞), P = 0.081
Duodenal mass	4 (1.0%)	0 (0%)	P = 0.253	1.58 (0.26, ∞), P = 0.353
Duodenal ulcer	2 (0.5%)	2 (1.2%)	P = 0.407	0.21 (0.02, 2.20), P = 0.179

IM: Intestinal metaplasia.

Table 4 Association among histopathological biopsy results and gastric intestinal metaplasia

	Frequency in patients with gastric IM,n = 468	Frequency in patients without gastric IM,n = 171	Univariate analysis	Multivariate analysis (OR)
Chronic gastritis	265 (56.6%)	55 (32.2%)	P < 0.001	2.56 (1.75, 3.76), P < 0.001
Gastric polyp	35 (7.5%)	11 (6.4%)	P = 0.669	1.07 (0.53, 2.31), P = 0.861
MALT lymphoma	5 (1.1%)	0 (0.0%)	P = 0.209	1.48 (0.26, ∞), P = 0.372
Erosive gastritis	1 (0.2%)	6 (3.5%)	P = 0.002	0.06 (0.0, 0.43), P = 0.003
H. pylori infection	46 (9.8%)	6 (3.5%)	P = 0.007	3.07 (1.33, 8.20), P = 0.007
Gastric ulcer	18 (3.8%)	0 (0%)	P = 0.003	6.97 (1.47, ∞), P = 0.015
Gastric dysplasia	19 (4.1%)	1 (0.6%)	P = 0.017	6.11 (1.07, 131.57), P = 0.038
Gastric cancer	21 (4.5%)	1 (0.6%)	P = 0.010	6.53 (1.17, 139.41), P = 0.027
Autoimmune metaplastic atrophic gastritis	12 (2.6%)	0 (0%)	P = 0.023	5.64 (1.36, ∞), P = 0.035
Esophagitis	5 (1.1%)	5 (2.9%)	P = 0.125	0.36 (0.09, 1.41), P = 0.138
Barrett’s esophagus	14 (3.0%)	13 (7.6%)	P = 0.016	0.28 (0.12, 0.63), P = 0.003
Esophageal dysplasia	2 (0.4%)	4 (2.3%)	P = 0.053	0.11 (0.01, 0.64), P = 0.014
Esophageal cancer	1 (0.2%)	1 (0.6%)	P = 0.535	0.13 (0.01, 9.88), P = 0.402
Eosinophilic esophagitis	1 (0.2%)	6 (3.5%)	P = 0.002	0.10 (0.00, 0.74), P = 0.020
Carcinoid tumor	10 (2.1%)	0 (0%)	P = 0.043	5.13 (1.02, ∞), P = 0.047
Duodenitis	2 (0.4%)	6 (3.5%)	P = 0.006	0.13 (0.02, 0.65), P = 0.012
Duodenal polyp	5 (1.1%)	1 (0.6%)	P = 0.645	1.2 (0.16, 29.49), P = 0.944
Duodenal ulcer	2 (0.4%)	0 (0%)	P = 0.536	0.63 (0.07, ∞), P = 0.628

IM: Intestinal metaplasia; H. pylori: Helicobacter pylori; MALT: Mucosa-associated lymphoid tissue.