High Salt Intake Is Associated with Atrophic Gastritis with Intestinal Metaplasia

Cancer Epidemiol Biomarkers Prev. 2017 Jul;26(7):1133-1138. doi: 10.1158/1055-9965.EPI-16-1024. Epub 2017 Mar 24.

Abstract

Background: Although several studies have investigated excessive salt intake as a risk factor for gastric precancerous lesions, such as atrophic gastritis and intestinal metaplasia, the evidence is insufficient to make a conclusion. We evaluated the association between gastric precancerous lesions and salt intake.Methods: From 2008 to 2015, the medical records of 728 subjects who underwent upper gastrointestinal endoscopy and sodium excretion in 24-hour urine tests were retrospectively reviewed. Sixty-six subjects were excluded due to diuretics use (n = 55), diagnosis with a gastric neoplasm (n = 4), or the cases of intestinal metaplasia in the absence of atrophy (n = 7), so 662 subjects were included. Atrophic gastritis and intestinal metaplasia were diagnosed by endoscopic findings. The subjects were grouped into three levels by tertiles of 24-hour urine sodium excretion.Results: A total of 192 (29.0%) had atrophic gastritis without intestinal metaplasia and 112 (16.9%) had atrophic gastritis with intestinal metaplasia. A total of 276 subjects (61.5%) were infected with Helicobacter pylori (H. pylori). In multivariate analyses, H. pylori infection [OR = 14.17; 95% confidence interval (CI), 7.12-28.22) was associated with atrophic gastritis without intestinal metaplasia. Highest levels of sodium excretion (OR = 2.870; 95% CI, 1.34-6.14), heavy smoking (≥20 pack-years) (OR = 2.75; 95% CI, 1.02-7.39), and H. pylori infection (OR = 3.96; 95% CI, 2.02-7.76) were associated with atrophic gastritis with intestinal metaplasia.Conclusions: Our endoscopy-based study suggested that high salt intake could be associated with an increased risk of atrophic gastritis with intestinal metaplasia.Impact: Low salt diet might be helpful to prevent gastric carcinogenesis. Cancer Epidemiol Biomarkers Prev; 26(7); 1133-8. ©2017 AACR.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Endoscopy, Gastrointestinal
  • Female
  • Gastric Mucosa / diagnostic imaging
  • Gastric Mucosa / microbiology
  • Gastric Mucosa / pathology
  • Gastritis, Atrophic / chemically induced
  • Gastritis, Atrophic / diagnostic imaging
  • Gastritis, Atrophic / epidemiology*
  • Gastritis, Atrophic / microbiology
  • Helicobacter Infections / diagnostic imaging
  • Helicobacter Infections / epidemiology*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / isolation & purification
  • Humans
  • Intestinal Mucosa / diagnostic imaging
  • Intestinal Mucosa / pathology*
  • Male
  • Metaplasia / chemically induced
  • Metaplasia / diagnostic imaging
  • Metaplasia / epidemiology
  • Middle Aged
  • Renal Elimination
  • Retrospective Studies
  • Risk Factors
  • Sodium Chloride, Dietary / adverse effects*
  • Sodium Chloride, Dietary / urine
  • Stomach Neoplasms / prevention & control*
  • Urinalysis / methods

Substances

  • Sodium Chloride, Dietary