Relationship between lifetime alcohol consumption and Helicobacter pylori infection

Association of Alcohol Drinking and Helicobacter pylori Infection : A Meta-analysis

BACKGROUND

The association between drinking and Helicobacter pylori infection was not clear in the literature. Owing to mixed and inconclusive results, a meta-analysis was conducted to summarize and clarify this association systematically.

METHODS

Based on a comprehensive search of PubMed, Embase, and Web of Science databases, studies investigating the association between drinking and H. pylori infection were retrieved. We evaluated the strength of this relationship using odds ratios (ORs) with 95% confidence intervals. Sensitivity analysis was also conducted.

RESULTS

A total of 24 individual studies were included in this meta-analysis. The risk of H. pylori infection was significantly lower in alcohol drinkers than nondrinkers (OR=0.83). People who drink wine (OR=0.90) or mixed types of alcoholic beverages (OR=0.78) had a lower risk of infection compared with those who drink beer. Among people aged 40 years or older, alcohol drinkers had a lower risk of H. pylori infection than nondrinkers (OR=0.68). Among people less than 40 years of age, alcohol drinking was not associated with H. pylori infection risk. Data showed that women were at a lower risk of H. pylori infection than men (OR=0.86).

CONCLUSIONS

This meta-analysis suggests that the risk of H. pylori infection among alcohol drinkers is lower than that of nondrinkers. Drinking wine and mixed types of alcohol are better at reducing H. pylori infection than drinking beer. Nonetheless, we discourage reducing H. pylori infection through drinking, which increases the risk of other diseases.

Inverse relations between Helicobacter pylori infection and risk of esophageal precancerous lesions in drinkers and peanut consumption

BACKGROUND

Helicobacter pylori (H. pylori) is a Gram-negative bacterium found in the upper digestive tract. Although H. pylori infection is an identified risk factor for gastric cancer, its role in esophageal squamous cell carcinoma (ESCC) remains a topic of much debate.

AIM

To evaluate the association between H. pylori infection and the risk of precancerous lesions of ESCC, and further explore the association between dietary factors and the risk of H. pylori infection.

METHODS

Two hundred patients with esophageal precancerous lesions (EPL) aged 63.01 ± 6.08 years and 200 healthy controls aged 62.85 ± 6.03 years were included in this case-control study. Epidemiological data and qualitative food frequency data were investigated. Enzyme-linked immunosorbent assay measuring serum immunoglobulin G antibodies was used to determine H. pylori seropositivity. An unconditional logistic regression model was used to assess the association between H. pylori infection and EPL risk dichotomized by gender, age, and the use of tobacco and alcohol, as well as the association between dietary factors and the risk of H. pylori infection.

RESULTS

A total of 47 (23.5%) EPL cases and 58 (29.0%) healthy controls had positive H. pylori infection. An inverse relation between H. pylori infection and the risk of EPL was found in the group of drinkers after adjustment for covariates [odds ratio (OR) = 0.32, 95% confidence interval (95%CI): 0.11-0.95]. Additionally, peanut intake was significantly associated with a decreased risk of H. pylori infection (OR = 0.39, 95%CI: 0.20-0.74).

CONCLUSION

Our study suggested that H. pylori infection may decrease the risk of EPL for drinkers in a rural adult Chinese population, and the consumption of peanut may reduce the risk of H. pylori infection. These findings should be framed as preliminary evidence, and further studies are required to address whether the mechanisms are related to the localization of lesions and alcohol consumption.

Effects of active and latent H. pylori infection coupled with chronic alcohol ingestion on cytokine profiles and markers of oxidative balance in men seropositive for H. pylori CagA Ab: An observational study

This study aimed to explore the effects of active and latent Helicobacter pylori infection coupled with alcohol consumption on cytokine profiles and markers of oxidative balance in men seropositive for H. pylori CagA Ab.The 100 male subjects were divided into groups with active H. pylori infection and H. pylori CagA Ab coupled with chronic alcohol ingestion (group A, n = 38), latent H. pylori infection with H. pylori CagA Ab coupled with chronic alcohol ingestion (group B, n = 30), and latent H. pylori infection with H. pylori CagA Ab without chronic alcohol ingestion (group C, n = 32).No differences in serum levels of CRP, IL-10, ADP, E-selectin, MDA, or SOD were detected between the 3 groups or between any 2 groups (all P > .05). The serum IL-6 and TNF-α concentrations in groups A and B were significantly lower than those in group C (P = .004, P = .005, P = .009, and P = .023). However, there were no differences in serum IL-6 and TNF-α between group A and group B (all P > .05).In conclusion, active or latent H. pylori infection coupled with chronic alcohol ingestion may decrease certain cytokines, that is, IL-6 and TNF-α, in men with H. pylori CagA Ab seropositivity. However, there was no difference in the detected cytokine profile between active and latent H. pylori infection coupled with chronic alcohol ingestion, and no changes were detected in markers of oxidative balance in men with H. pylori CagA Ab.

Binge drinking and total alcohol consumption from 16 to 43 years of age are associated with elevated fasting plasma glucose in women: results from the northern Swedish cohort study

BACKGROUND

Studies have indicated that moderate alcohol consumption is associated with lower incidence of diabetes in women. However, not only the amount but also the drinking pattern could be of importance when assessing the longitudinal relation between alcohol and glucose. Also, there is a lack of studies on alcohol use beginning in adolescence on adult glucose levels. The aim was to examine the association between total alcohol consumption and binge drinking between ages 16 and 43 and fasting plasma glucose at age 43.

METHODS

Data were retrieved from a 27-year prospective cohort study, the Northern Swedish Cohort. In 1981, all 9th grade students (n = 1083) within a municipality in Sweden were invited to participate. There were re-assessments at ages 18, 21, 30 and 43. This particular study sample consisted of 897 participants (82.8%). Fasting plasma glucose (mmol/L) was measured at a health examination at age 43. Total alcohol consumption (in grams) and binge drinking were calculated from alcohol consumption data obtained from questionnaires.

RESULTS

Descriptive analyses showed that men had higher levels of fasting plasma glucose as compared to women. Men also reported higher levels of alcohol consumption and binge drinking behavior. Linear regressions showed that total alcohol consumption in combination with binge drinking between ages 16 and 43 was associated with elevated fasting plasma glucose at age 43 in women (beta = 0.14, p = 0.003) but not in men after adjustment for BMI, hypertension and smoking at age 43.

CONCLUSIONS

Our findings indicate that reducing binge drinking and alcohol consumption among young and middle-aged women with the highest consumption might be metabolically favorable for their future glucose metabolism.

Online Registry for Nationwide Database of Current Trend of Helicobacter pylori Eradication in Korea: Interim Analysis

Eradication of Helicobacter pylori using first-line therapy is becoming less effective. Subjects who had been treated for H. pylori infection were prospectively enrolled through an on-line database registry from October 2010 to December 2012. Demographic data, detection methods, treatment indication, regimens, durations, compliance, adverse events, and eradication results for H. pylori infection were collected. Data of 3,700 patients from 34 hospitals were analyzed. The overall eradication rate of the first-line therapy was 73.0%. Eradication failure was significantly associated with old age, concomitant medication, and comorbidity. Regional differences in eradication rates were observed. The most common first-line therapy was proton pump inhibitor-based triple therapy (standard triple therapy, STT) for 7 days (86.8%). The eradication rates varied with regimens, being 73% in STT, 81.8% in bismuth-based quadruple therapy, 100% in sequential therapy, and 90.3% in concomitant therapy. The eradication rate in treatment-naïve patients was higher than that in patients previously treated for H. pylori infection (73.8% vs. 58.5%, P < 0.001). The overall eradication rate for second-line therapy was 84.3%. There was no statistical difference in eradication rates among various regimens. H. pylori eradication rate using STT is decreasing in Korea and has become sub-optimal, suggesting the need for alternative regimens to improve the efficacy of first-line therapy for H. pylori infection.

US Time Series Evidence regarding Alcohol-Related Risk of Oral Cancers and Protection against Stomach Cancers: Are Higher Concentration Beverages Different?

Autoregressive integrated moving average modeling procedures are utilized on population-level mortality rates for oral and stomach cancers in relation to per capita consumption of total alcohol, beer, wine, spirits and cigarettes to estimate long-term population-level relationships between alcohol consumption series and oral and stomach cancer mortality rates, and to determine whether higher-concentration alcoholic beverages, as represented by spirits, are more strongly related to these cancers than beer or wine.

Total alcohol consumption is found to increase oral cancer rates by 3.5% per litre of ethanol. Spirits consumption is found to be the only significant predictor in multivariate models. For stomach cancers, total alcohol and especially spirits are found to be protective, with each litre of spirits associated with a 10% reduction in rates. High-concentration beverages, as represented by spirits, are found to be significant risk factors for oral cancers but potentially protective for stomach cancer.

Influence of H. pylori CagA Coupled with Alcohol Consumption on Cytokine Profiles in Men

The aim of this study was to evaluate the effect of Helicobacter pylori (H pylori) cytotoxin-associated gene A (CagA) coupled with chronic alcohol ingestion on cytokine profiles.A total of 215 male subjects were divided into the following 4 groups: 130 alcohol H pylori CagA-negative consumers (CagA-) (group A), 50 alcohol H pylori CagA-positive consumers (CagA+) (group B), 24 nonalcohol H pylori CagA-negative consumers (group C), and 11 nonalcohol H pylori CagA-positive consumers (group D). The serum CagA, C-reactive protein (CRP), interleukin (IL)-6, IL-10, E-selectin, adiponectin (ADP), and tumor necrosis factor-α (TNF-α) levels were measured through enzyme-linked immunosorbent assays (ELISAs).After adjusting for age and mean alcohol drinking history, a multivariable linear regression analysis revealed that the mean daily alcohol consumption, IL-6, TNF-α, and ADP levels were significantly increased with increases in the serum CagA concentrations (P = 0.008, P = 0.000, P = 0.000, and P = 0.006, respectively). The serum IL-6 and IL-10 levels of group A were significantly lower than those of group B (all P = 0.000). Furthermore, the serum IL-6 and IL-10 levels of groups A and C were significantly lower than those of group D (all P = 0.000), and the serum IL-6 and IL-10 levels of group C were significantly lower than those of group B (all P = 0.000). The serum ADP and E-selectin levels of groups B and D were significantly higher than those of group A (P = 0.000). The serum ADP levels of group B were significantly higher than those of group C (P = 0.000), and the serum ADP and E-selectin levels of group C were significantly lower than those of group D (P = 0.000 and P = 0.005, respectively). Finally, the serum TNF-α levels of groups B, C, and D were significantly higher than those of group A (all P = 0.000), and the serum TNF-α levels of group C were significantly higher than those of group D (P = 0.005).In conclusion, H pylori CagA may result in significantly higher levels of several inflammatory markers in both alcohol consumers and nonalcohol consumers. However, chronic alcohol ingestion coupled with H pylori CagA positivity does not result in significant changes in cytokine profiles.

Alcohol intake and Helicobacter pylori infection: a dose-response meta-analysis of observational studies

Background Alcohol intake has been suggested to have an impact on the development of many chronic diseases. How alcohol intake may modulate risk of Helicobacter pylori (H. pylori) infection, however, remains a subject open for investigation. A dose-response meta-analysis was performed of epidemiological studies to better quantify this relationship. Materials and methods Twelve observational articles were identified. The summary odds ratio (OR) and confidence intervals (CI) were calculated for alcohol drinkers vs non-drinkers. The summary OR estimates were obtained using the random-effects model and dose-response meta-analysis. Sub-group and sensitivity analysis were also conducted. Results The summary OR was 0.78 (95% CI = 0.69-0.89). The dose-response analysis demonstrated that for drinkers of 10, 15, 30, 60 and 96 g/day alcohol intake, the estimated ORs were 0.80 (95% CI = 0.76-0.85), 0.79 (95% CI = 0.75-0.84), 0.83 (95% CI = 0.78-0.87), 0.85 (95% CI = 0.78-0.93) and 0.87 (95% CI = 0.70-1.06), respectively, compared to non-drinkers. The inverse relationship between alcohol intake and H. pylori infection was consistent, regardless of sex, age, geographic areas, detection methods or beverage types.

CONCLUSION

Evidence from these observational studies suggests that moderate alcohol intake is associated with a reduction in H. pylori infection of ∼ 22% and may facilitate elimination of H. pylori.

Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the ¹³C-Urea breath test

Background

Helicobacter pylori is an important global pathogen infecting approximately 50% of the world’s population. This study was undertaken in order to estimate the prevalence rate of Helicobacter pylori infections among adults living in Turkey and to investigate the associated risk factors.

Method

This study was a nationally representative cross sectional survey, using weighted multistage stratified cluster sampling. All individuals aged ≥18 years in the selected households were invited to participate in the survey. Ninety two percent (n = 2382) of the households in 55 cities participated; 4622 individuals from these households were tested with the ¹³C-Urea breath test. Helicobacter pylori prevalence and associated factors were analysed by the t test, chi square and multiple logistic regression with SPSS11.0.

Results

The weighted overall prevalence was 82.5% (95% CI: 81.0-84.2) and was higher in men. It was lowest in the South which has the major fruit growing areas of the country. The factors included in the final model were sex, age, education, marital status, type of insurance (social security), residential region, alcohol use, smoking, drinking water source. While education was the only significant factor for women, residential region, housing tenure, smoking and alcohol use were significant for men in models by sex.

Conclusion

In Turkey, Helicobacter pylori prevalence was found to be very high. Individuals who were women, elderly adults, single, had a high educational level, were living in the fruit growing region, had social security from Emekli Sandigi, were drinking bottled water, non smokers and regular alcohol consumers, were under less risk of Helicobacter pylori infection than others.

Alcohol consumption and chronic atrophic gastritis: population-based study among 9,444 older adults from Germany

Moderate alcohol consumption has been suggested to facilitate elimination of Helicobacter pylori infection which is a key risk factor for chronic atrophic gastritis (CAG) and gastric cancer. The aim of our study was to assess the association of alcohol consumption with CAG among older adults from Germany. In the baseline examination of ESTHER, a population-based study conducted in Saarland, serological measurements of pepsinogen I and II (for CAG definition) and H. pylori antibodies were taken in 9,444 subjects aged 50-74 years. Moderate current (<60 g/week) and lifetime (<or=51,376 g, lowest quartile) alcohol consumption were found to be associated with significantly reduced CAG risk compared to alcohol abstinence with adjusted odds ratios of 0.71 (0.55-0.90) and 0.73 (0.55-0.96), respectively. Inverse associations with CAG were observed for moderate alcohol consumption from both beer and wine, and were slightly attenuated after additional adjustment for H. pylori infection. Our results are consistent with the hypothesis that moderate alcohol consumption may be inversely related to CAG, partly through facilitating the elimination of H. pylori. However, the observed patterns suggest that other mechanisms are likely to contribute to the association as well.

Seroprevalence of Helicobacter pylori among Tunisian blood donors (outpatients), symptomatic patients and control subjects

OBJECTIVES

Helicobacter pylori is a worldwide infection, although little data are available in the Tunisian population. The aims of our study were to detect the prevalence of H. pylori in a blood-donor population (n=250) and in another population of hospital-consulting patients comprising 87 symptomatic patients and 59 controls, and to determine the factors that influence the prevalence.

MATERIALS AND METHODS

Study subjects answered a standardized questionnaire, and IgG anti-H. pylori and anti-cag were detected by ELISA. In the second population, culture and cagA polymerase chain reaction were performed.

RESULTS

The seroprevalence of H. pylori in blood donors was 64%, and 11% had anti-cag. All patients positive for anti-cag were also positive for anti-H. pylori antibodies. The seroprevalence of H. pylori was 99.3% in the hospital-consulting patients, of whom 55.5% were positive for anti-cag. The difference between the anti-cag and symptomatic patients (66.7%) and controls (39%) was significant. Symptomatic patients had a higher rate of anti-cag (66.7%) compared with the controls (39%) and blood donors (11%).

CONCLUSION

H. pylori seroprevalence in blood donors is low (64%) compared with symptomatic patients (99.3%), and anti-cag was statistically associated with symptomatic patients and pathology. Also, some environmental factors were correlated with H. pylori seroprevalence.

[Analysis of Helicobacter pylori infection in a healthy Panamanian population]

Infection with Helicobacter pylori carrying a cagA virulence gene is a potential risk factor for gastric cancer. Since obtaining clinical isolates from healthy subjects is difficult, epidemiological analysis of cagA-positive H. pylori in healthy populations is not well studied. To assess H. pylori infection in a healthy population, we applied coprodiagnostic analysis to determine H. pylori infection prevalence. H. pylori antigen in stool specimens was detected by immunochrmoatograpy in 54.1% of participants. The average age in the H. pylori-positive group was higher than in the negative group. The alcohol intake group showed a significantly higher H. pylori prevalence. The genotype of cagA was assessed by polymerase chain reaction after bacterial DNA extraction from H. pylori-positive stool specimens. Only 20.0% of participants in sample in which H. pylori DNA was detected were infected with cagA-positive H. pylori, but all cagA-positive H. pylori was of the East-Asian genotype. These results indicate that a significant number of healthy adults in Panama are infected with H. pylori, but the majority of bacteria are less virulent. Alcohol intake may be a risk factor for H. pylori infection.

Prevalence of Helicobacter pylori infection and identification of risk factors in rural and urban Beijing, China

BACKGROUND

The prevalence of Helicobacter pylori is higher in developing countries such as China. The aim of this study was to investigate the prevalence of H. pylori in one rural and one urban region of Beijing, China.

MATERIALS AND METHODS

Healthy individuals in rural Pinggu and urban Haidian voluntarily participated in this study. The diagnosis of H. pylori infection was reached using the (13)C-urea breath test. Associations between H. pylori and sex, age, living area (i.e. rural vs urban), education level, smoking, and alcohol consumption were evaluated.

RESULTS

Of the 1232 included subjects, 54.7% of tested individuals residing in Pinggu and 41.3% in Haidian were positive for H. pylori. In urban region, more individuals were negative for H. pylori (429 of 731), whereas in the rural region, more individuals were positive for H. pylori (p < .05). Univariate analysis identified geographic area and lower education and annual income as significant factors associated with H. pylori. Men in rural areas were more likely than women in rural areas to be infected, and both men and women in the rural area were more likely to be positive for H. pylori than men and women in the urban area (all p < .05).

CONCLUSIONS

H. pylori infection is common in both rural and urban regions of Beijing. Residing in a rural area, having a lower family income, and lower education level are significant risk factors associated with infection.

Meta-analysis of different test indicators: Helicobacter pylori infection and the risk of colorectal cancer

BACKGROUND AND AIMS

Recent studies have demonstrated the relationship between Helicobacter pylori infection and the risk of colorectal carcinoma. However, the results of these studies remain controversial as the studies were relatively small in size and partially differed in designs, and so we reviewed the published studies and carried out a meta-analysis to further explore this relationship.

MATERIALS AND METHODS

We performed an extensive systematic review to find all the published case-control studies up to Jan. 2007 using electronic searching, hand searching, and reference lists of retrieved articles. Odds ratio (OR) was employed to evaluate the relationship of H. pylori infection and risk of colorectal cancer. Summary estimates were obtained using random effect models according to the result of a statistical test for heterogeneity across the studies. The presence of possible publication bias was assessed using different statistical approaches.

RESULTS

Thirteen studies were included, and summary OR 1.49 (95% confidence interval [CI] 1.17-1.91) was estimated for the association between H. pylori infection and colorectal cancer. Summary OR 1.56 (95% CI 1.14-2.14) was estimated for the association between immunoglobulin G antibody and colorectal cancer risk. By trimming and filling, the number of inputted studies was zero, and summary OR was still 1.49 (95% CI 1.17-1.91). The graphical funnel plot appeared asymmetrical, but there was no statistical evidence of publication bias. The method of fail-safe suggested that the effect of publication bias was small.

CONCLUSION

Current evidence, though limited, suggests that there is a possible increase in risk of colorectal cancer because of H. pylori infection.

Helicobacter pylori infection in Ontario: prevalence and risk factors

BACKGROUND

Helicobacter pylori has been classified by the World Health Organization as a type I carcinogen. Nearly 50% of the world's population is estimated to be infected with H pylori. Prevalence patterns of the infection are different between developing and developed countries. The present study had two objectives - to estimate the prevalence of H pylori infection in Ontario, and to evaluate the relationship between the infection and various demographic characteristics and selected lifestyle factors.

METHODS

Ten microlitres of plasma were aliquoted from stored blood of 1306 men and women, 50 to 80 years of age, from Ontario. The blood samples belonged to control patients of a colorectal cancer population-based study group. Serological testing was used to detect H pylori infection; information was obtained on dietary intake and lifestyle habits, as well as past and present medical history, education, income, number of siblings, ethnicity and place of birth.

RESULTS

The overall weighted seroprevalence of H pylori was 23.1% (95% CI 17.7% to 29.5%), with men having higher infection rates (29.4%, 95% CI 21.1% to 39.3%) than women (14.9%, 95% CI 10.1% to 21.4%). Seroprevalence of the infection increased significantly with age and number of siblings. Increased risk was also associated with being nonwhite, being born outside of Canada and immigrating at 20 years of age or older. An inverse association with seroprevalence was found for education and alcohol consumption.

CONCLUSION

The prevalence of H pylori infection in Ontario is comparable with that of other developed countries. Age, sex, number of siblings, ethnicity, place of birth and age at immigration are among the factors associated with H pylori infection.

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