Increase in the Prevalence of Atrophic Gastritis Among Adults Age 35 to 44 Years Old in Northern Sweden Between 1990 and 2009

BACKGROUND & AIMS

Atrophic corpus gastritis (ACG) is believed to be an early precursor of gastric adenocarcinoma. We aimed to investigate trends of ACG in Northern Sweden, from 1990 through 2009, and to identify possible risk factors.

METHODS

We randomly selected serum samples collected from 5284 participants in 1990, 1994, 1999, 2004, and 2009, as part of the population-based, cross-sectional Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study (ages, 35-64 y). Information was collected on sociodemographic, anthropometric, lifestyle, and medical factors using questionnaires. Serum samples were analyzed for levels of pepsinogen I to identify participants with functional ACG; data from participants with ACG were compared with those from frequency-matched individuals without ACG (controls). Blood samples were analyzed for antibodies against Helicobacter pylori and Cag pathogenicity island protein A. Associations were estimated with unconditional logistic regression models.

RESULTS

Overall, 305 subjects tested positive for functional ACG, based on their level of pepsinogen I. The prevalence of ACG in participants age 55 to 64 years old decreased from 124 per 1000 to 49 per 1000 individuals between 1990 and 2009. However, the prevalence of ACG increased from 22 per 1000 to 64 per 1000 individuals among participants age 35 to 44 years old during this time period. Cag pathogenicity island protein A seropositivity was associated with risk for ACG (odds ratio, 2.29; 95% confidence interval, 1.69-3.12). Other risk factors included diabetes, low level of education, and high body mass index. The association between body mass index and ACG was confined to individuals age 35 to 44 years old; in this group, overweight and obesity were associated with a 2.8-fold and a 4.7-fold increased risk of ACG, respectively.

CONCLUSIONS

Among residents of Northern Sweden, the prevalence of ACG increased from 1990 through 2009, specifically among adults age 35 to 44 years old. The stabilizing seroprevalence of H pylori and the increasing prevalence of overweight and obesity might contribute to this unexpected trend. Studies are needed to determine whether these changes have affected the incidence of gastric cancer.

Discordance in Secular Trends of Bone Mineral Density Measurements in Different Ages of Postmenopausal Women

BACKGROUND

Age-adjusted bone mineral density (BMD) in postmenopausal women decreases in developed countries whereas incidence of osteoporotic fracture decreases or remains stable. We investigated secular trends of bone density from 2008 to 2017 among different age groups of postmenopausal women.

METHODS

We analyzed BMD data obtained from health check-ups of 4,905 postmenopausal women during three survey cycles from 2008 to 2017. We divided them into 3 groups by age (50-59 years, 60-69 years, and 70 years or more) and observed the transition of lumbar and femoral BMD in each group, before and after adjusting for variables that may affect BMD.

RESULTS

Age-adjusted BMD, bone mineral content (BMC), and T-score demonstrated a declining trend over the survey period at lumbar spine (-2.8%), femur neck (-3.5%) and total femur (-4.3%), respectively. In the analysis for the age groups, the BMD, BMC, and T-score presented linear declining trend (-6.1%) in younger postmenopausal women while women aged over 70 or more showed linear increasing trends (+6.3%) at lumbar spine during the survey period. Femoral neck and total femur BMD demonstrated a declining linear trend only in the 50-59 and 60-69 years groups (-5.5%, -5.2%, respectively), but not in the 70 years or more group.

CONCLUSION

BMD in younger postmenopausal women has decreased considerably but has increased or plateaued in elderly women. This discordance of BMD trends among different age groups may contribute to decreased incidence of osteoporotic fracture despite a recent declining BMD trend in postmenopausal women.