Risk factors for intestinal metaplasia in a southeastern Chinese population: an analysis of 28,745 cases

Abstract

Purpose: To identify risk factors for intestinal metaplasia in a southeastern Chinese population.

Methods: Subjects who underwent upper GI endoscopy and endoscopic biopsy in the First Affiliated Hospital of Nanjing Medical University from 2008 to 2013 were included into this study. Various demographic, geographic, clinical and pathological data were analyzed separately to identify risk factors for intestinal metaplasia.

Results: The incidence of intestinal metaplasia differed significantly in 17 municipal areas ranging from 16.79 to 38.56% and was positively correlated with the age range of 40-70 years, male gender, gastric ulcer, bile reflux, Helicobacter pylori infection, atrophic gastritis, dysplasia, gastric cancer, degree of chronic and acute inflammation, and gross domestic product per capita (P < 0.01). Multivariate linear regression analysis indicated that only gross domestic product per capita revealed a significant difference in the incidence of intestinal metaplasia among all factors mentioned.

Conclusion: This study confirms age, male gender, gastric ulcer, bile reflux, H. pylori infection, severe degree of chronic and acute inflammation to be the risk factors for intestinal metaplasia. We speculate that the gross domestic product per capita of different areas may be a potential independent risk factor impacting the incidence of intestinal metaplasia.

Keywords: Gross domestic product per capita; Helicobacter pylori infection; Inflammation; Intestinal metaplasia; Risk factors.

Fig. 1

Trends of the grade of IM in different age groups

Fig. 2

Scatter plot and fitting straight line of the linear correlation analysis of the relationship between IM and GDP per capita