Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas.

BACKGROUND The significance ofHelicobacter pylori(H. pylori) infection and atrophic gastritis (AG) in the prevalence of colorectal adenomas has been examined in a limited number of studies. However, these studies reported disputed conclusions. AIM To investigate whetherH. pyloriinfection, AG, andH. pylori-related AG increase the risk of colorectal adenomas. METHODS This retrospective cross-sectional study included 6018 health-check individuals. The relevant data for physical examination, laboratory testing,C-13-urea breath testing, gastroscopy, colonoscopy and histopathological examination of gastric and colorectal biopsies were recorded. Univariate and multivariate logistic regression analyses were performed to determine the association betweenH. pylori-related AG and colorectal adenomas. RESULTS Overall, 1012 subjects (16.8%) were diagnosed with colorectal adenomas, of whom 143 (2.4%) had advanced adenomas. Among the enrolled patients, the prevalence ofH. pyloriinfection and AG was observed as 49.5% (2981/6018) and 10.0% (602/6018), respectively. Subjects withH. pyloriinfection had an elevated risk of colorectal adenomas (adjusted odds ratio [OR] of 1.220, 95% confidence interval (CI): 1.053-1.413,P= 0.008) but no increased risk of advance adenomas (adjusted OR = 1.303, 95%CI: 0.922-1.842,P= 0.134). AG was significantly correlated to an increased risk of colorectal adenomas (unadjusted OR = 1.668, 95%CI: 1.352-2.059,P< 0.001; adjusted OR = 1.237, 95%CI: 0.988-1.549,P= 0.064).H. pyloriinfection accompanied by AG was significantly associated with an increased risk of adenomas (adjusted OR = 1.491, 95%CI: 1.103-2.015,P= 0.009) and advanced adenomas (adjusted OR = 1.910, 95%CI: 1.022-3.572,P= 0.043). CONCLUSION H. pylori-related AG was associated with a high risk of colorectal adenomas and advanced adenomas in Chinese individuals.