期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 31, 期 8, 页码 1630-1637出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-22-0234
关键词
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资金
- VicHealth and Cancer Council Victoria
- Australian National Health and Medical Research Council [209057, 396414, 1074383]
- Cancer Council Victoria
- NHMRC [504708]
- Australian Government Research Training Program Scholarship
- Deakin University
- Cancer Institute NSW Early Career Fellowship [2019/ECF1082]
- UNSW Scientia Fellowship
The study found that men, but not women, who were H. pylori sero-negative had increased risks of GERD and Barrett's esophagus, possibly due to differences in patterns of H. pylori-induced atrophic antral gastritis between sexes.
Background: Mechanisms for how Helicobacter pylori infection affects risk of gastroesophageal reflux disease (GERD) and Barrett's esophagus are incompletely understood and might differ by sex. Methods: In a case-control study nested in the Melbourne Collaborative Cohort Study with 425 GERD cases and 169 Barrett's esophagus cases (identified at 2007-2010 follow-up), we estimated sex-specific odds ratios for participants who were H. pylori sero-negative versus seropositive at baseline (1990-1994). To explore possible mechanisms, we (i) compared patterns of H. pylori-induced gastritis by sex using serum pepsinogen-I and gastrin-17 data and (ii) quantified the effect of H. pylori seronegativity on Barrett's esophagus mediated by GERD using causal mediation analysis. Results: For men, H. pylori seronegativity was associated with 1.69-fold [95% confidence interval (CI), 1.03-2.75] and 2.28-fold (95% CI, 1.27-4.12) higher odds of GERD and Barrett's esophagus, respectively. No association was observed for women. H. pylori- induced atrophic antral gastritis was more common in men (68%) than in women (56%; P 1/4 0.015). For men, 5 of the 15 per 1,000 excess Barrett's esophagus risk from being seronegative were medi-ated by GERD. Conclusions: Men, but not women, who were H. pylori sero-negative had increased risks of GERD and Barrett's esophagus. A possible explanation might be sex differences in patterns of H. pylori-induced atrophic antral gastritis, which could lead to less erosive reflux for men. Evidence of GERD mediating the effect of H. pylori on Barrett's esophagus risk among men supports this proposed mechanism. Impact: The findings highlight the importance of investigating sex differences in the effect of H. pylori on risk of GERD and Barrett's esophagus in future studies.
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