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Zhang F, Pu K, Wu Z, Zhang Z, Liu X, Chen Z, Ye Y, Wang Y, Zheng Y, Zhang J, An F, Zhao S, Hu X, Li Y, Li Q, Liu M, Lu H, Zhang H, Zhao Y, Yuan H, Ding X, Shu X, Ren Q, Gou X, Hu Z, Wang J, Wang Y, Guan Q, Guo Q, Ji R, Zhou Y. Prevalence and associated risk factors of Helicobacter pylori infection in the Wuwei cohort of north-western China. Trop Med Int Health 2020; 26:290-300. [PMID: 33159827 DOI: 10.1111/tmi.13517] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the prevalence of Helicobacter pylori infection and risk factors and to serotype the strains in Wuwei, located in north-western China, which has a high incidence of gastric cancer. METHODS Helicobacter pylori infection was analysed in 21 291 adults by 14 C-urea breath test, and H. pylori antibody were detected in 9183 serum samples by latex immunoturbidimetric method. The correlation of H. pylori infection with demographic-economic, lifestyle factors and medical history among the participants was determined by questionnaire. The antibodies against H. pylori urease, VacA and CagA in serum were determined by dot immunobinding assay. RESULTS The infection rate of H. pylori was 53.0%, and 90.1% of strains were type I strains. The H. pylori infection rate was higher among farmers (OR = 1.34, 95% CI: 1.19-1.50) and individuals who had a junior high school or higher education level (OR = 1.10, 95% CI: 1.06-1.15), and was lower in older individuals (OR = 0.86, 95% CI: 0.83-0.90), individuals with high income (OR = 0.93, 95% CI: 0.90-0.95), individuals with a habit of eating quickly (OR = 0.93, 95% CI: 0.87-0.99) and individuals who consumed more fruit and vegetables (OR = 0.90, 95% CI: 0.85-0.95). Individuals with history of cholecystitis/cholecystolithiasis, hypertension and asthma were negatively correlated with H. pylori infection (P < 0.05). CONCLUSION The prevalence of H. pylori infection is high in Wuwei. The major prevalent strain is type I strain. Age, education, occupation, household income, consumption of fruit and vegetables, and habit of eating quickly are independent risk factors for H. pylori infection, which is also associated with individuals with a history of extragastric diseases.
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Affiliation(s)
- Fuhua Zhang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Ke Pu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Zhengqi Wu
- Department of Gastroenterology, Gansu Province Wuwei Cancer Hospital, Wuwei, China
| | - Zhiyi Zhang
- Department of Gastroenterology, Gansu Province Wuwei Cancer Hospital, Wuwei, China
| | - Xin Liu
- Department of Gastroenterology, Hospital 940, Joint Logistic Support Force of PLA, Lanzhou, China
| | - Zhaofeng Chen
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuwei Ye
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Jinhua Zhang
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou, China
| | - Feng An
- Department of Gastroenterology, Wuwei People's Hospital, Wuwei, China
| | - Shijun Zhao
- Department of Gastroenterology, Wuwei Liangzhou Hospital, Wuwei, China
| | - Xiaobin Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Youpeng Li
- Department of Gastroenterology, Minqin County People's Hospital, Wuwei, China
| | - Qiang Li
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Min Liu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hong Lu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hongling Zhang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yue Zhao
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hao Yuan
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Xiangping Ding
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou, China
| | - Xiaochuang Shu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Qian Ren
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Xi Gou
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Zenan Hu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Jun Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuling Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Quanlin Guan
- Department of Oncology Surgery, the First Hospital of Lanzhou University, Lanzhou, China
| | - Qinghong Guo
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yongning Zhou
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
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Beltrán-Anaya FO, Poblete TM, Román-Román A, Reyes S, de Sampedro J, Peralta-Zaragoza O, Rodríguez MÁ, del Moral-Hernández O, Illades-Aguiar B, Fernández-Tilapa G. The EPIYA-ABCC motif pattern in CagA of Helicobacter pylori is associated with peptic ulcer and gastric cancer in Mexican population. BMC Gastroenterol 2014; 14:223. [PMID: 25539656 PMCID: PMC4302603 DOI: 10.1186/s12876-014-0223-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/17/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Helicobacter pylori chronic infection is associated with chronic gastritis, peptic ulcer, and gastric cancer. Cytotoxin-associated gene A (cagA)-positive H. pylori strains increase the risk of gastric pathology. The carcinogenic potential of CagA is linked to its polymorphic EPIYA motif variants. The goals of this study were to investigate the frequency of cagA-positive Helicobacter pylori in Mexican patients with gastric pathologies and to assess the association of cagA EPIYA motif patterns with peptic ulcer and gastric cancer. METHODS A total of 499 patients were studied; of these, 402 had chronic gastritis, 77 had peptic ulcer, and 20 had gastric cancer. H. pylori DNA, cagA, and the EPIYA motifs were detected in total DNA from gastric biopsies by PCR. The type and number of EPIYA segments were determined by the electrophoretic patterns. To confirm the PCR results, 20 amplicons of the cagA 3' variable region were sequenced, and analyzed in silico, and the amino acid sequence was predicted with MEGA software, version 5. The odds ratio (OR) was calculated to determine the associations between the EPIYA motif type and gastric pathology and between the number of EPIYA-C segments and peptic ulcers and gastric cancer. RESULTS H. pylori DNA was found in 287 (57.5%) of the 499 patients, and 214 (74%) of these patients were cagA-positive. The frequency of cagA-positive H. pylori was 74.6% (164/220) in chronic gastritis patients, 73.6% (39/53) in peptic ulcer patients, and 78.6% (11/14) in gastric cancer patients. The EPIYA-ABC pattern was more frequently observed in chronic gastritis patients (79.3%, 130/164), while the EPIYA-ABCC sequence was more frequently observed in peptic ulcer (64.1%, 25/39) and gastric cancer patients (54.5%, 6/11). However, the risks of peptic ulcer (OR = 7.0, 95% CI = 3.3-15.1; p < 0.001) and gastric cancer (OR = 5.9, 95% CI = 1.5-22.1) were significantly increased in individuals who harbored the EPIYA-ABCC cagA gene pattern. CONCLUSIONS cagA-positive H. pylori is highly prevalent in southern Mexico, and all CagA variants were of the western type. The cagA alleles that code for EPIYA-ABCC motif patterns are associated with peptic ulcers and gastric cancer.
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