American Journal of Epidemiology Vol. 155, No. 11 : 1054-1059
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Relation between Helicobacter pylori cagA Status and Risk of Peptic Ulcer Disease
1 Japan-Hawaii Cancer Study, Kuakini Medical Center, Honolulu, HI.
2 Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN.
3 Department of Pathology, University of Cincinnati Medical Center, Cincinnati, OH.
4 Department of Veterans Affairs Medical Center, Nashville, TN.
Although colonization with any Helicobacter pylori strain is associated with peptic ulcer, it is uncertain whether the risk is greater with cagA+ or cagA- strains, which differ in their biology. A nested case-control study was done, based on a cohort of 5,443 Japanese-American men examined on the Hawaiian island of Oahu from 1967 to 1970. A total of 150 men with gastric ulcer, 65 with duodenal ulcer, and 14 with both diseases were identified. The authors matched the 229 cases with 229 population controls and tested their serum for immunoglobulin G antibodies to H. pylori and immunoglobulin G antibodies to the cagA product of H. pylori using enzyme-linked immunosorbent assays. Persons with H. pylori positivity had an odds ratio of 4.0 (95% confidence interval (CI): 1.9, 8.5) for gastric ulcer and 2.5 (95% CI: 0.8, 7.4) for duodenal ulcer. For CagA positivity, the odds ratios were 1.4 (95% CI: 0.9, 2.4) for gastric ulcer and 2.6 (95% CI: 1.1, 5.8) for duodenal ulcer. Subjects who were seropositive for both H. pylori and CagA had an odds ratio of 4.4 (95% CI: 1.8, 10.5) for gastric ulcer and 5.8 (95% CI: 1.1, 30.0) for duodenal ulcer. The results suggest that colonization with a cag+ H. pylori strain elevates the risk beyond that of a cag- H. pylori strain for both gastric and duodenal ulcers.
duodenal ulcer; Helicobacter pylori; peptic ulcer; stomach ulcer
Abbreviations: CI, confidence interval; IgG, immunoglobulin G
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