The preventive factors for aspirin-induced peptic ulcer: aspirin ulcer and corpus atrophy

J Gastroenterol. 2009;44(7):717-25. doi: 10.1007/s00535-009-0068-0. Epub 2009 May 16.

Abstract

Purpose: Interleukin-1beta (IL-1beta) polymorphisms are associated with peptic ulcer and atrophic gastritis. This study aimed to examine effects of corpus atrophy and the genotypes of genes related to peptic ulcer, including IL-1beta, on risk of aspirin ulcer.

Methods: 232 patients taking 100 mg of aspirin for cardiovascular diseases, of whom 40 had peptic ulcer, were enrolled. IL1beta, interleukin-1 receptor antagonist (IL-1RN), tumor necrosis factor (TNF)-alpha, cyclooxygenase (COX)-1, cytochrome p450 2C9 (CYP2C9), UDP-glucuronosyltransferase (UGT1A6) genotypes were determined, and serum pepsinogen levels were measured.

Results: The polymorphisms of IL-1beta-511/-31 were significantly associated with peptic ulcer, but other genotypes were not. Serum pepsinogen I and II levels and I/II ratio were significantly higher in the ulcer group than in the non-ulcer group. Taking PPI [adjusted odds ratio (OR), 0.09; 95% confidence interval (CI), 0.02-0.39], pepsinogen I of less than 50 ng/ml (OR, 0.24; 95% CI, 0.10-0.56) and IL-1beta-511 T carrier (OR, 0.42; 95% CI, 0.18-0.93) were significantly associated with peptic ulcer.

Conclusions: Hypoacidity related to corpus atrophy as well as taking PPI seems to be preventively associated with development of peptic ulcer among low dose aspirin users.

MeSH terms

  • Aged
  • Aspirin / adverse effects*
  • Atrophy / complications
  • Cyclooxygenase 1 / genetics
  • Female
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Interleukin-1beta / genetics*
  • Male
  • Pepsinogens / blood*
  • Peptic Ulcer / chemically induced*
  • Peptic Ulcer / genetics*
  • Peptic Ulcer / pathology
  • Polymorphism, Genetic*

Substances

  • Interleukin-1beta
  • Pepsinogens
  • Cyclooxygenase 1
  • PTGS1 protein, human
  • Aspirin