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Eur J Gastroenterol Hepatol. 2019 May;31(5):593-598. doi: 10.1097/MEG.0000000000001389.

Sex differences in the prevalence of Helicobacter pylori infection: an individual participant data pooled analysis (StoP Project).

Author information

1
EPIUnit - Instituto de Saúde Pública.
2
Department of Clinical Sciences and Community Health.
3
Universidad de Cantabria - IDIVAL, Santander.
4
CIBER Epidemiología y Salud Pública, Madrid.
5
Research Group on Gene-Environment Interactions and Health, University of León, Spain.
6
Instituto Nacional de Salud Pública, Morelos.
7
Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran.
8
Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut, USA.
9
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan.
10
Nikkei Disease Prevention Center, São Paulo, Brazil.
11
Facultad de Medicina, UNAM, Coyoacán, Mexico.
12
Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
13
Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
14
Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.
15
Medical Informatics Center, Peking University, Peking, China.
16
Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada.
17
Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
18
Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
19
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
20
Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, Latvia.
21
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
22
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
23
Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.

Abstract

BACKGROUND:

Helicobacter pylori (H. pylori) infection is more frequent among men, though the magnitude of the association might be inaccurate due to potential misclassification of lifetime infection and publication bias. Moreover, infection is common, and most studies are cross-sectional. Thus, prevalence ratios (PRs) may be easier to interpret than odds ratios (ORs).

AIM:

The aim of this study was to quantify the association between sex and H. pylori infection using controls from 14 studies from the Stomach Cancer Pooling (StoP) Project.

PARTICIPANTS AND METHODS:

H. pylori infection was defined based on IgG serum antibody titers or multiplex serology. Participants were also classified as infected if gastric atrophy was present, based on histological examination or serum pepsinogen (PG) levels (PG I≤70 and PG I/II ratio≤3). Summary ORs and PRs, adjusted for age, social class and smoking, and corresponding 95% confidence intervals (CIs), were estimated through random-effects meta-analysis.

RESULTS:

Men had significantly higher OR (OR: 1.33, 95% CI: 1.04-1.70) and PR (PR: 1.05, 95% CI: 1.00-1.10) of infection, with stronger associations among hospital-based or older controls. Results were similar when considering the presence of gastric atrophy to define infection status, particularly among participants older than 65 years.

CONCLUSION:

This collaborative pooled-analysis supports an independent effect of sex on the prevalence of H. pylori infection, while minimizing misclassification of lifetime infection status and publication bias.

PMID:
30839435
DOI:
10.1097/MEG.0000000000001389
[Indexed for MEDLINE]

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