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

Qin-Fen Chen; Xiao-Dong Zhou; Dan-Hong Fang; En-Guang Zhang; Chun-Jing Lin; Xiao-Zhen Feng; Na Wang; Jian-Sheng Wu; Dan Wang; Wei-Hong Lin

doi:10.3748/wjg.v26.i37.5682

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

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

Authors

Affiliations

¹ Department of Physical Examination Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
² Department of Cardiovascular Medicine, The Key Laboratory of Cardiovascular Diseases of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
³ Department of Physical Examination Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China. linweihong@wmu.edu.cn.

Abstract

Background: The significance of Helicobacter pylori (H. pylori) infection and atrophic gastritis (AG) in the prevalence of colorectal adenomas has been examined in a limited number of studies. However, these studies reported disputed conclusions.

Aim: To investigate whether H. pylori infection, AG, and H. pylori-related AG increase the risk of colorectal adenomas.

Methods: This retrospective cross-sectional study included 6018 health-check individuals. The relevant data for physical examination, laboratory testing, ¹³C-urea breath testing, gastroscopy, colonoscopy and histopathological examination of gastric and colorectal biopsies were recorded. Univariate and multivariate logistic regression analyses were performed to determine the association between H. pylori-related AG and colorectal adenomas.

Results: Overall, 1012 subjects (16.8%) were diagnosed with colorectal adenomas, of whom 143 (2.4%) had advanced adenomas. Among the enrolled patients, the prevalence of H. pylori infection and AG was observed as 49.5% (2981/6018) and 10.0% (602/6018), respectively. Subjects with H. pylori infection had an elevated risk of colorectal adenomas (adjusted odds ratio [OR] of 1.220, 95% confidence interval (CI): 1.053-1.413, P = 0.008) but no increased risk of advance adenomas (adjusted OR = 1.303, 95%CI: 0.922-1.842, P = 0.134). AG was significantly correlated to an increased risk of colorectal adenomas (unadjusted OR = 1.668, 95%CI: 1.352-2.059, P < 0.001; adjusted OR = 1.237, 95%CI: 0.988-1.549, P = 0.064). H. pylori infection accompanied by AG was significantly associated with an increased risk of adenomas (adjusted OR = 1.491, 95%CI: 1.103-2.015, P = 0.009) and advanced adenomas (adjusted OR = 1.910, 95%CI: 1.022-3.572, P = 0.043).

Conclusion: H. pylori-related AG was associated with a high risk of colorectal adenomas and advanced adenomas in Chinese individuals.

Keywords: Adenomas; Atrophy; Colorectal; Gastritis; Health-check; Helicobacter pylori.

MeSH terms

Adenoma* / diagnosis
Adenoma* / epidemiology
Colorectal Neoplasms* / diagnosis
Colorectal Neoplasms* / epidemiology
Cross-Sectional Studies
Gastritis, Atrophic* / diagnosis
Gastritis, Atrophic* / epidemiology
Helicobacter Infections* / complications
Helicobacter Infections* / diagnosis
Helicobacter Infections* / epidemiology
Helicobacter pylori*
Humans
Retrospective Studies
Risk Factors