Prevalence of H. pylori Infection and Chronic Atrophic Gastritis in the Dominican Children

标题：多米尼加儿童幽门螺杆菌感染和慢性萎缩性胃炎患病率目的：了解多米尼加儿童幽门螺杆菌感染和慢性萎缩性胃炎（CAG）患病率及幽门螺杆菌CagA抗体阳性情况，并通过多因素分析阐明与幽门螺杆菌感染和慢性萎缩性胃炎相关的几个因素。方法：在多米尼加共和国的一所幼儿园、一所幼儿园、一所小学和一所初中的儿童中，有1331名志愿者以书面形式签署了知情同意书。每个人都进行了健康检查和抽血，测量血清胃蛋白酶原I和II、胃蛋白酶原I/II比率、血清胃泌素、幽门螺杆菌抗体和针对幽门螺杆菌的CagA抗体，并回答了上消化道疾病问卷。结果：不同年龄、性别患者幽门螺杆菌感染率（0.000 ~ 0.467）和CAG（0.000 ~ 0.158）存在差异。多明尼加儿童C…More agA抗体幽门螺杆菌阳性随年龄增长而增加。以幽门螺杆菌感染为因变量，采用正似然法对与幽门螺杆菌感染相关的因素进行逐步回归分析。该模型包括25个自变量（胃肠道疾病相关的主观症状、既往病史、家族史、环境、生活方式、性别和年龄）和受试者检测数据；血清胃泌素水平。在逻辑回归模型的最后一步中，未感染幽门螺杆菌的受试者中，93.5%的人被正确分类。在幽门螺杆菌感染的受试者中，27.7%的人被正确分类。总体而言，75.6%的受试者被正确分类。男性与女性幽门螺杆菌感染的比值比为1.465。年龄增加1岁时，幽门螺杆菌感染的比值比为1.326。当共同生活的子女数量增加一人时，幽门螺杆菌感染的比值比为1.185。以腹泻为主观症状的幽门螺杆菌感染与无腹泻者的比值比为1.567。当受试者血清胃泌素水平升高1 pg/ml时，幽门螺杆菌感染的优势比为1.008。为明确慢性萎缩性胃炎（CAG）的相关因素，选择慢性萎缩性胃炎（CAG）为因变量，采用正似然法进行逐步回归分析。该模型包括9个自变量（胃肠道疾病相关主观症状、既往病史、家族史、环境、生活方式、性别、年龄、受试者检测数据、血清胃泌素水平、幽门螺杆菌感染、CagA对幽门螺杆菌的抗体）。在逻辑回归模型的最后一步，在没有CAG的受试者中，99.0%的人正确分类。在CAG患者中，18.5%的人正确分类。总体而言，88.0%的受试者被正确分类。当受试者血清胃泌素水平升高1 pg/ml时，CAG的优势比为1.006。有CagA抗体者与无CagA抗体者在幽门螺杆菌感染中的比值比为2.090。幽门螺杆菌感染组与未感染组CAG的比值比为2.738。幽门螺杆菌感染与CagA抗幽门螺杆菌抗体的性别交叉表显示，CagA抗体阳性在男孩和女孩之间无显著差异。然而，在没有幽门螺杆菌感染的受试者中，我们的CagA检测试剂盒检测出的CagA抗体阳性约为20%。结论：血清胃泌素、抗幽门螺杆菌CagA抗体和幽门螺杆菌感染是儿童CAG的良好标志物。幽门螺杆菌CagA抗体阳性与慢性萎缩性胃炎的关系有待进一步研究。少

TITLE : Prevalence of H. pylori Infection and Chronic Atrophic Gastritis in the Dominican ChildrenPURPOSE : To show the prevalence of H. pylori infection and chronic atrophic gastritis (CAG) and the positivity of CagA antibody to H. pylori in the Dominican children, and to clarify the several factors that related to H. pylori infection and CAG by multivariate analysis.METHODS : One thousand and thirty one subjects who have given us the informed consent in writing were volunteers from children of the nursery school, a kindergarten, a primary school, and a junior high school in the Dominican Republic. Each individual underwent a health checkup and blood sampling for measurement of serum pepsinogen I and II, pepsinogen I/II ratio, serum gastrin, H. pylori antibodies, and CagA antibody to H. pylori, and responded to a questionnaire on upper digestive tract diseases.RESULTS : The prevalence of H. pylori infection (0.000-0.467) and CAG (0.000-0.158) varied by age and sex. The positivity of C … More agA antibody to H. pylori for boys and girls increased by advancing age in the Dominican children.To show the factors related to be H. pylori infection was done the stepwise regression analysis using forward likelihood procedure and choosing H. pylori infection as the dependent variable. The model included twenty-five independent variables (gastrointestinal disease-related subjective symptom, past history, and family history, environment, lifestyle, gender and age, and subjects examined data ; serum gastrin level. In this final step of the logistic regression model, of the subjects without H. pylori infection, 93.5% were correctly classified. Of the subjects with H. pylori infection, 27.7% were correctly classified. Overall, 75.6% of all subjects were correctly classified. The odds ratio of H. pylori infection in male subjects was 1.465 to female subjects. The odds ratio of H. pylori infection was 1.326 when age of the subject increase one year old. The odds ratio of H. pylori infection was 1.185 when numbers of children who live together increase one person. The odds ratio of H. pylori infection in subjects with diarrhea as subjective symptom was 1.567 to those without diarrhea. The odds ratio of H. pylori infection was 1.008 when serum gastrin level of the subject increases 1 pg/ml.To clarify the factors related to be chronic atrophic gastritis (CAG) was done the stepwise regression analysis using forward likelihood procedure and choosing chronic atrophic gastritis (CAG) as the dependent variable. The model included nine independent variables (gastrointestinal disease-related subjective symptom, past history, and family history, environment, lifestyle, gender, and age, subjects examined data; serum gastrin level, H. pylori infection, and antibody of CagA to H. pylori). In this final step of the logistic regression model, of the subjects without CAG, 99.0% were correctly classified. Of the subjects with CAG, 18.5% were correctly classified. Overall, 88.0% of all subjects were correctly classified. The odds ratio of CAG was 1.006 when serum gastrin level of the subject increased 1 pg/ml. The odds ratio of CAG in subjects with antibody of CagA to H. pylori infection was 2.090 to those without antibody of CagA. The odds ratio of CAG in subjects with H. pylori infection was 2.738 to those without H. pylori infection.The Cross tabulation by gender between H. pylori infection and antibody of CagA to H. pylori showed it that the positivity of CagA antibody has not seen significant differences between boys and girls. However, the positivity of CagA antibody was about 20 % by our CagA measurement kit in subjects1 who have had no H. pylori infection.CONCLUSIONS :Our results indicated that serum gastrin, CagA antibody to H. pylori, and H. pylori infection are a good marker of CAG even in children. To clarify the relationship between the positivity of CagA antibody to H. pylori and chronic atrophic gastritis need further study. Less