Prevalence and risk factors of Helicobacter pylori infection in Korea: nationwide multicenter study over 13 years

Seon Hee Lim, Jin-Won Kwon, Nayoung Kim, Gwang Ha Kim, Jung Mook Kang, Min Jung Park, Jeong Yoon Yim, Heung Up Kim, Gwang Ho Baik, Geom Seog Seo, Jeong Eun Shin, Young-Eun Joo, Joo Sung Kim, Hyun Chae Jung, Seon Hee Lim, Jin-Won Kwon, Nayoung Kim, Gwang Ha Kim, Jung Mook Kang, Min Jung Park, Jeong Yoon Yim, Heung Up Kim, Gwang Ho Baik, Geom Seog Seo, Jeong Eun Shin, Young-Eun Joo, Joo Sung Kim, Hyun Chae Jung

Abstract

Background: The aim of this study was to evaluate the time trend of seropositivity of Helicobacter pylori (H. pylori) over the period of 13 years in an asymptomatic Korean population, and investigate associated risk factors.

Methods: This cross-sectional nationwide multicentre study surveyed anti-H. pylori IgG antibodies in 19,272 health check-up subjects (aged [greater than and equal to]16 years) in 2011. Risk factors for H. pylori infection were investigated using logistic regression. Seropositivity in asymptomatic subjects without H. pylori eradication was compared between the years 1998 and 2005. Birth cohort effects were also evaluated.

Results: After exclusion of subjects with a history of H. pylori eradication therapy (n = 3,712, 19.3%) and gastric symptoms (n = 4,764, 24.7%), the seroprevalence of H. pylori infection was 54.4% in 10,796 subjects. This was significantly lower than the seroprevalence of 59.6% in 2005 and that of 66.9% in 1998, and this decrease of seropositivity of H. pylori became widespread across all ages and in most areas of the country. This decreasing trend could be explained by cohort analysis. All younger birth cohorts had a lower seroprevalence of H. pylori than older birth cohorts at the same age. Decreased seroprevalence within the same birth cohorts also accounted for this phenomenon. Clinical risk factors of H. pylori infection were higher cholesterol level ([greater than and equal to] 240 mg/dl) (OR = 1.33; 95% CI = 1.14-1.54), male gender, older age, low income, and residence in a rural area.

Conclusions: A decreasing trend of H. pylori seroprevalence due to a birth cohort effect requires further studies on its related human host factors as well as socio-economic and hygienic factors. In addition, the relationship between H. pylori infection and high cholesterol level needs more investigation regarding underlying pathogenesis.

Figures

Figure 1
Figure 1
Study flowchart in 2011.
Figure 2
Figure 2
Trends of seroprevalence of H. pylori infection in asymptomatic subjects without a history of H. pylori eradication in 1998[10], 2005[9], and 2011. (*p < 0.05) Seroprevalence by sex (Panel A), by geographic area (Panel B) and by age (Panel B).
Figure 3
Figure 3
Seroprevalence of H. pylori infection in asymptomatic subjects without a history of H. pylori eradication in birth cohort against age. Each line connects the values for the same cohort-group in different age group. For example, the first line shows the seroprevalence of H. pylori in a birth cohort of 1972–77 for ages of 22–39 years, and the second line shows the seroprevalence of H. pylori in a birth cohort of 1966–71 for ages of 28–45 years. All younger birth cohorts at the same age have a lower seroprevalence of H. pylori than older birth cohorts.

References

    1. Egan BJ, Holmes K, O'Connor HJ, O'Morain CA. Helicobacter pylori gastritis, the unifying concept for gastric diseases. Helicobacter. 2007;12(Suppl 2):39–44.
    1. Parsonnet J. The incidence of Helicobacter pylori infection. Aliment Pharmacol Ther. 1995;9(Suppl 2):45–51.
    1. Roosendaal R, Kuipers EJ, Buitenwerf J, Meuwissen SG, van Kamp GJ, Vandenbroucke-Grauls CM. Helicobacter pylori and the birth cohort effect: evidence of a continuous decrease of infection rates in childhood. Am J Gastroenterol. 1997;92:1480–1482.
    1. Taylor DN, Blaser MJ. The epidemiology of Helicobacter pylori infection. Epidemiol Rev. 1991;13:42–59.
    1. Graham DY, Malaty HM, Evans DG, Evans DJ Jr, Klein PD, Adam E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991;100:1495–1501.
    1. van Zanten SJ V, Pollak PT, Best LM, Bezanson GS, Marrie T. Increasing prevalence of Helicobacter pylori infection with age: continuous risk of infection in adults rather than cohort effect. J Infect Dis. 1994;169:434–437.
    1. Banatvala N, Mayo K, Megraud F, Jennings R, Deeks JJ, Feldman RA. The cohort effect and Helicobacter pylori. J Infect Dis. 1993;168:219–221.
    1. Kosunen TU, Aromaa A, Knekt P, Salomaa A, Rautelin H, Lohi P, Heinonen OP. Helicobacter antibodies in 1973 and 1994 in the adult population of Vammala, Finland. Epidemiol Infect. 1997;119:29–34.
    1. Yim JY, Kim N, Choi SH, Kim YS, Cho KR, Kim SS, Seo KS, Kim HU, Baik GH, Sin CS, Cho SH, Oh BH. Seroprevalence of Helicobacter pylori in South Korea. Helicobacter. 2007;12:333–340.
    1. Kim JH, Kim HY, Kim N, Kim SW, Kim JG, Kim JJ, Roe IH SJK, Sim JG, Ahn H, Yoon BC, Lee SW, Lee YC, Chung IS, Jung HY, Hong WS, Choi KW. Seroepidemiological study of Helicobacter pylori infection in asymptomatic people in South Korea. J Gastroenterol Hepatol. 2001;16:969–975.
    1. Kim SY, Ahn JS, Ha YJ, Doh HJ, Jang MH, Chung SI, Park HJ. Serodiagnosis of Helicobacter pylori infection in Korean patients using enzyme-linked immunosorbent assay. J Immunoassay. 1998;19:251–270.
    1. Kwon JW, Song YM, Sung J, Sohn Y, Cho SI. Varying patterns of BMI increase in sex and birth cohorts of Korean adults. Obesity (Silver Spring) 2007;15:277–282.
    1. Shiota S, Murakami K, Fujioka T, Yamaoka Y. Population-based strategies for Helicobacter pylori-associated disease management: a Japanese perspective. Expert Rev Gastroenterol Hepatol. 2010;4:149–156.
    1. Malaty HM, El-Kasabany A, Graham DY, Miller CC, Reddy SG, Srinivasan SR, Yamaoka Y, Berenson GS. Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood. Lancet. 2002;359:931–935.
    1. Kim N, Lim SH, Lee KH, Kim JM, Cho SI, Jung HC, Song IS. Seroconversion of Helicobacter pylori in Korean male employees. Scand J Gastroenterol. 2005;40:1021–1027.
    1. Perez-Perez GI, Rothenbacher D, Brenner H. Epidemiology of Helicobacter pylori infection. Helicobacter. 2004;9(Suppl 1):1–6.
    1. The EUROGAST Study Group. Epidemiology of, and risk factors for, Helicobacter pylori infection among 3194 asymptomatic subjects in 17 populations. Gut. 1993;34:1672–1676.
    1. Moayyedi P, Axon AT, Feltbower R, Duffett S, Crocombe W, Braunholtz D, Richards IDG, Dowell AC, Forman D. Relation of adult lifestyle and socioeconomic factors to the prevalence of Helicobacter pylori infection. Int J Epidemiol. 2002;31:624–631.
    1. Danesh J, Peto R. Risk factors for coronary heart disease and infection with Helicobacter pylori: meta-analysis of 18 studies. BMJ. 1998;316:1130–1132.
    1. Oshima T, Ozono R, Yano Y, Oishi Y, Teragawa H, Higashi Y, Yoshizumi M, Kambe M. Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects. J Am Coll Cardiol. 2005;45:1219–1222.
    1. Paximadas S, Pagoni ST, Kosmidis M, Tsarouchas X, Christou M, Chatziantonakis N, Papachilleos P. The lipid profile in adults with negative or positive antibody Helicobacter pylori [abstract] Atherosclerosis supplement. 2005;6:74.
    1. Kucukazman M, Yavuz B, Sacikara M, Asilturk Z, Ata N, Ertugrul DT, Yalcin AA, Yenigum EC, Kizilca G, Okten H, Akin KO, Nazligul Y. The relationship between updated Sydney System score and LDL cholesterol levels in patients infected with Helicobacter pylori. Dig Dis Sci. 2009;54:604–607.
    1. Laurila A, Bloigu A, Nayha S, Hassi H, Leinonen M, Saikku P. Association of Helicobacter pylori infection with elevated serum lipids. Atherosclerosis. 1999;142:207–210.
    1. Majka J, Rog T, Konturek PC, Konturek SJ, Bielanski W, Kowalsky M, Szczudlik A. Influence of chronic Helicobacter pylori infection on ischemic cerebral stroke risk factors. Med Sci Moni. 2002;8:CR675–CR684.
    1. Gallin JI, Kaye D, O'Leary WM. Serum lipids in infection. N Engl J Med. 1969;281:1081–1086.
    1. Grunfeld C, Gulli R, Moser AH, Gavin LA, Feingold KR. Effect of tumor necrosis factor administration in vivo on lipoprotein lipase activity in various tissues of the rat. J Lipid Res. 1989;30:579–585.
    1. Memon RA, Grunfeld C, Moser AH, Feingold KR. Tumor necrosis factor mediates the effects of endotoxin on cholesterol and triglyceride metabolism in mice. Endocrinology. 1993;132:2246–2253.

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