[Effects of cytotoxin-associated gene a (CagA) antibodies with Helicobacter pylori infection and lifestyle on chronic atrophic gastritis].

OBJECTIVE: We conducted a population-based study to examine differences in risk of developing chronic atrophic gastritis in association with Helicobacter pylori (H. pylori) infection, with and without the presence of cytotoxin-associated gene A (CagA) antibodies, as well as to determine associations with the lifestyle factors. METHOD: Seventy hundred and thirty eight residents (295 men and 443 women) aged 30-64 living in a village in the southern part of Fukuoka Prefecture had an annual health checkup, and all participated in our study. We obtained information on their lifestyle with informed consent and measured the levels of serum pepsinogen I (PGI) and pepsinogen II (PGII), H. pylori and CagA antibodies. Chronic atrophic gastritis was defined as both PGI < 70 micrograms/l and PGI/PGII < 3.0. RESULTS: The odds ratios for development of chronic atrophic gastritis were 4.26 (95% CI, 2.22-8.17) for CagA-positive H. pylori infection and 3.87 (95% CI, 1.95-7.68) for CagA-negative H. pylori infection in males, and 4.92 (95% CI, 3.06-7.92) and 3.02 (95% CI, 1.69-5.41) respectively for females, as compared with H. pylori-negative subjects. Regarding the relationship between chronic atrophic gastritis and lifestyle factors, high consumption of green tea was found to be negatively associated with risk, particularly with CagA-positive H. pylori infection. CONCLUSIONS: Our results suggest that a CagA-positive H. pylori infection is associated with an elevated risk for developing chronic atrophic gastritis as compared with Cag-negative H. pylori infection.