Skip to main content

Advertisement

SpringerLink
Log in

Study of Association Between Atrophic Gastritis and Body Mass Index: A Cross-Sectional Study in 10,197 Japanese Subjects

  • ORIGINAL ARTICLE
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Objectives The aim of this study was to elucidate the association between body mass index (BMI) and both Helicobacter pylori and atrophic gastritis. Methods The study involved 10,197 subjects participating in a Japanese mass endoscopic gastric cancer screening program. Atrophic gastritis was assessed by pepsinogen I to II ratio. Results In logistic regression models, BMI had an inverse association with atrophic gastritis, with the odds ratios (OR) decreasing progressively to 0.67 (95% confidence interval [CI] 0.57–0.79, P < 0.0001) in the highest BMI quintiles (BMI ≥25.66) group compared with the lowest BMI quintiles (BMI <20.97) group. In linear regression models, atrophic gastritis predicted BMI (regression coefficient −0.326, 95% CI −0.469, −0.184, P < 0.0001), whereas H. pylori antibody was not a predictor (regression coefficient 0.072, 95% CI −0.053, 0.198, P = 0.3). Conclusions A small, inverse association between BMI and atrophic gastritis was found in the general population. In contrast, no association was observed between H. pylori seropositivity and BMI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obes Res. 2001;9(Suppl 4):228S–233S. doi:10.1038/oby.2001.123.

    Article  PubMed  Google Scholar 

  2. James PT, Rigby N, Leach R. International obesity task F: the obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil. 2004;11:3–8. doi:10.1097/01.hjr.0000114707.27531.48.

    Article  PubMed  Google Scholar 

  3. Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289:76–79. doi:10.1001/jama.289.1.76.

    Article  PubMed  Google Scholar 

  4. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–1638. doi:10.1056/NEJMoa021423.

    Article  PubMed  Google Scholar 

  5. Chow WH, Blot WJ, Vaughan TL, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90:150–155. doi:10.1093/jnci/90.2.150.

    Article  PubMed  CAS  Google Scholar 

  6. Lagergren J, Bergstrom R, Nyren O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med. 1999;130:883–890.

    PubMed  CAS  Google Scholar 

  7. Merry AH, Schouten LJ, Goldbohm RA, van den Brandt PA. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study. Gut. 2007;56:1503–1511. doi:10.1136/gut.2006.116665.

    Article  PubMed  Google Scholar 

  8. Sipponen P, Helske T, Jarvinen P, Hyvarinen H, Seppala K, Siurala M. Fall in the prevalence of chronic gastritis over 15 years: analysis of outpatient series in Finland from 1977, 1985, and 1992. Gut. 1994;35:1167–1171. doi:10.1136/gut.35.9.1167.

    Article  PubMed  CAS  Google Scholar 

  9. Fujisawa T, Kumagai T, Akamatsu T, Kiyosawa K, Matsunaga Y. Changes in seroepidemiological pattern of Helicobacter pylori and hepatitis A virus over the last 20 years in Japan. Am J Gastroenterol. 1999;94:2094–2099. doi:10.1111/j.1572-0241.1999.01283.x.

    Article  PubMed  CAS  Google Scholar 

  10. Haruma K, Okamoto S, Kawaguchi H, et al. Reduced incidence of Helicobacter pylori infection in young Japanese persons between the 1970s and the 1990s. J Clin Gastroenterol. 1997;25:583–586. doi:10.1097/00004836-199712000-00006.

    Article  PubMed  CAS  Google Scholar 

  11. de Vries AC, Meijer GA, Looman CW, et al. Epidemiological trends of pre-malignant gastric lesions: a long-term nationwide study in the Netherlands. Gut. 2007;56:1665–1670. doi:10.1136/gut.2007.127167.

    Article  PubMed  Google Scholar 

  12. Yamaji Y, Mitsushima T, Ikuma H, et al. Inverse background of Helicobacter pylori antibody and pepsinogen in reflux oesophagitis compared with gastric cancer: analysis of 5732 Japanese subjects. Gut. 2001;49:335–340. doi:10.1136/gut.49.3.335.

    Article  PubMed  CAS  Google Scholar 

  13. Watabe H, Mitsushima T, Yamaji Y, et al. Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–768. doi:10.1136/gut.2004.055400.

    Article  PubMed  CAS  Google Scholar 

  14. Dinis-Ribeiro M, Yamaki G, Miki K, Costa-Pereira A, Matsukawa M, Kurihara M. Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen. 2004;11:141–147. doi:10.1258/0969141041732184.

    Article  PubMed  CAS  Google Scholar 

  15. Miki K, Ichinose M, Shimizu A, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn. 1987;22:133–141.

    PubMed  CAS  Google Scholar 

  16. Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen MD, Ledin T, Szesci PB. The ratio of pepsinogen A to pepsinogen C: a sensitive test for atrophic gastritis. Scand J Gastroenterol. 1989;24:870–876. doi:10.3109/00365528909089228.

    Article  PubMed  CAS  Google Scholar 

  17. Yamamoto I, Fukuda Y, Mizuta T, et al. Evaluation of nine commercial serodiagnostic kits for the detection of Helicobacter pylori infection in Japan (in Japanese with English abstract). Res Forum Dig Dis. 1994;1:75–85.

    Google Scholar 

  18. van Oijen MG, Josemanders DF, Laheij RJ, van Rossum LG, Tan AC, Jansen JB. Gastrointestinal disorders and symptoms: does body mass index matter? Neth J Med. 2006;64:45–49.

    PubMed  Google Scholar 

  19. Choi S, Lim YJ, Park SK. Risk factor analysis for metaplastic gastritis in Koreans. World J Gastroenterol. 2006;12:2584–2587.

    PubMed  Google Scholar 

  20. Weck MN, Stegmaier C, Rothenbacher D, Brenner H. Epidemiology of chronic atrophic gastritis: population-based study among 9444 older adults from Germany. Aliment Pharmacol Ther. 2007;26:879–887.

    Article  PubMed  CAS  Google Scholar 

  21. Karita M, Noriyasu A, Kosako E, Teramukai S, Matsumoto S. Relationship between pepsinogen I&II and H. pylori infection considered with grade of atrophy and gastroduodenal diseases. Dig Dis Sci. 2003;48:1839–1845. doi:10.1023/A:1025423902479.

    Article  PubMed  CAS  Google Scholar 

  22. Broutet N, Plebani M, Sakarovitch C, Sipponen P, Megraud F. Eurohepygast Study G: Pepsinogen A, pepsinogen C, and gastrin as markers of atrophic chronic gastritis in European dyspeptics. Br J Cancer. 2003;88:1239–1247. doi:10.1038/sj.bjc.6600877.

    Article  PubMed  CAS  Google Scholar 

  23. Brenner H, Rothenbacher D, Weck MN. Epidemiologic findings on serologically defined chronic atrophic gastritis strongly depend on the choice of the cutoff-value. Int J Cancer. 2007;121:2782–2786. doi:10.1002/ijc.22992.

    Article  PubMed  CAS  Google Scholar 

  24. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402:656–660. doi:10.1038/45230.

    Article  PubMed  CAS  Google Scholar 

  25. Nakazato M, Murakami N, Date Y, et al. A role for ghrelin in the central regulation of feeding. Nature. 2001;409:194–198. doi:10.1038/35051587.

    Article  PubMed  CAS  Google Scholar 

  26. Wren AM, Small CJ, Ward HL, et al. The novel hypothalamic peptide ghrelin stimulates food intake and growth hormone secretion. Endocrinology. 2000;141:4325–4328. doi:10.1210/en.141.11.4325.

    Article  PubMed  CAS  Google Scholar 

  27. Isomoto H, Ueno H, Saenko VA, et al. Impact of Helicobacter pylori infection on gastric and plasma ghrelin dynamics in humans. Am J Gastroenterol. 2005;100:1711–1720. doi:10.1111/j.1572-0241.2005.41492.x.

    Article  PubMed  CAS  Google Scholar 

  28. Isomoto H, Ueno H, Nishi Y, et al. Circulating ghrelin levels in patients with various upper gastrointestinal diseases. Dig Dis Sci. 2005;50:833–838. doi:10.1007/s10620-005-2648-z.

    Article  PubMed  CAS  Google Scholar 

  29. Delgado-Aros S, Locke GR III, Camilleri M, et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol. 2004;99:1801–1806. doi:10.1111/j.1572-0241.2004.30887.x.

    Article  PubMed  Google Scholar 

  30. Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372:425–432. doi:10.1038/372425a0.

    Article  PubMed  CAS  Google Scholar 

  31. Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998;394:790–793. doi:10.1038/29547.

    Article  PubMed  CAS  Google Scholar 

  32. Cinti S, de Matteis R, Ceresi E, et al. Leptin in the human stomach. Gut. 2001;49:155. doi:10.1136/gut.49.1.155.

    Article  PubMed  CAS  Google Scholar 

  33. Nishi Y, Isomoto H, Uotani S, et al. Enhanced production of leptin in gastric fundic mucosa with Helicobacter pylori infection. World J Gastroenterol. 2005;11:695–699.

    PubMed  CAS  Google Scholar 

  34. Salles N, Menard A, Georges A, et al. Effects of Helicobacter pylori infection on gut appetite peptide (leptin, ghrelin) expression in elderly inpatients. J Gerontol. 2006;61:1144–1150.

    Google Scholar 

  35. Gong DH, Turner B, Bhaskar KR, Lamont JT. Lipid binding to gastric mucin: protective effect against oxygen radicals. Am J Physiol. 1990;259:G681–G686.

    PubMed  CAS  Google Scholar 

  36. Kato I, Vivas J, Plummer M, et al. Environmental factors in Helicobacter pylori-related gastric precancerous lesions in Venezuela. Cancer Epidemiol Biomarkers Prev. 2004;13:468–476.

    PubMed  Google Scholar 

  37. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–789. doi:10.1056/NEJMoa001999.

    Article  PubMed  CAS  Google Scholar 

  38. Sipponen P, Seppala K, Aarynen M, Helske T, Kettunen P. Chronic gastritis and gastroduodenal ulcer: a case control study on risk of coexisting duodenal or gastric ulcer in patients with gastritis. Gut. 1989;30:922–929. doi:10.1136/gut.30.7.922.

    Article  PubMed  CAS  Google Scholar 

  39. Azuma T, Suto H, Ito Y, et al. Eradication of Helicobacter pylori infection induces an increase in body mass index. Aliment Pharmacol Ther. 2002;16(Suppl 2):240–244. doi:10.1046/j.1365-2036.16.s2.31.x.

    Article  PubMed  Google Scholar 

  40. Myllyluoma E, Ahlroos T, Veijola L, Rautelin H, Tynkkynen S, Korpela R. Effects of anti-Helicobacter pylori treatment and probiotic supplementation on intestinal microbiota. Int J Antimicrob Agents. 2007;29:66–72. doi:10.1016/j.ijantimicag.2006.08.034.

    Article  PubMed  CAS  Google Scholar 

  41. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022–1023. doi:10.1038/4441022a.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Conflict of interest

The guarantor of the article is Hirotsugu Watabe. The following are the author contributions: protocol design and management Toru Mitsushima, Yutaka Yamaji, Takao Kawabe, and Masao Omata; data collection and management Hirotsugu Watabe, Toru Mitsushima, Yutaka Yamaji, and Makoto Okamoto; data analyses Hirotsugu Watabe and Kenneth E.L. McColl; development of the manuscript by Hirotsugu Watabe, Mohammad H Derakhshan, Yutaka Yamaji, Masao Omata, and Kenneth E.L. McColl.

Author information

Authors and Affiliations

  1. Medical Sciences, Gardiner Institute, Western Infirmary, University of Glasgow, Glasgow, G11 6NT, UK

    Hirotsugu Watabe, Mohammad H. Derakhshan & Kenneth E. L. McColl

  2. Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Hirotsugu Watabe, Yutaka Yamaji, Makoto Okamoto, Takao Kawabe & Masao Omata

  3. Kameda Cancer Screening Center, Kamogawa, Chiba, Japan

    Toru Mitsushima

Authors
  1. Hirotsugu Watabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Mitsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad H. Derakhshan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yutaka Yamaji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Makoto Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takao Kawabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masao Omata
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kenneth E. L. McColl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenneth E. L. McColl.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Cite this article

Watabe, H., Mitsushima, T., Derakhshan, M.H. et al. Study of Association Between Atrophic Gastritis and Body Mass Index: A Cross-Sectional Study in 10,197 Japanese Subjects. Dig Dis Sci 54, 988–995 (2009). https://doi.org/10.1007/s10620-008-0468-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0468-7

Keywords

Search

Navigation