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Sex Differences in the Prevalence of Helicobacter Pylori Infection: An Individual Participant Data Pooled Analysis (Stop Project) Publisher Pubmed



Ferro A1 ; Morais S1 ; Pelucchi C3 ; Dierssensotos T5, 6 ; Martin V6, 7 ; Lopezcarrillo L8 ; Malekzadeh R10, 16 ; Tsugane S12 ; Hamada GS13 ; Hidaka A12 ; Hernandezramirez RU8 ; Lopezcervantes M9 ; Zaridze D14 ; Maximovitch D14 Show All Authors
Authors
  1. Ferro A1
  2. Morais S1
  3. Pelucchi C3
  4. Dierssensotos T5, 6
  5. Martin V6, 7
  6. Lopezcarrillo L8
  7. Malekzadeh R10, 16
  8. Tsugane S12
  9. Hamada GS13
  10. Hidaka A12
  11. Hernandezramirez RU8
  12. Lopezcervantes M9
  13. Zaridze D14
  14. Maximovitch D14
  15. Pourfarzi F10, 11
  16. Zhang ZF15
  17. Yu GP17
  18. Pakseresht M10, 18, 19
  19. Ye W20
  20. Plymoth A21
  21. Leja M22
  22. Gasenko E22
  23. Derakhshan MH10, 23
  24. Negri E4
  25. La Vecchia C3
  26. Peleteiro B1, 2
  27. Lunet N1, 2
Show Affiliations
Authors Affiliations
  1. 1. EPIUnit-Instituto de Saude Publica, Portugal
  2. 2. Departamento de Ciencias da Saude Publica e Forenses e Educacao Medica, Faculdade de Medicina, Universidade Do Porto, Al. Prof. Hernani Monteiro, 4200-319, Portugal
  3. 3. Department of Clinical Sciences and Community Health, Portugal
  4. 4. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
  5. 5. Universidad de Cantabria-IDIVAL, Santander, Spain
  6. 6. CIBER Epidemiologia y Salud Publica, Madrid, Spain
  7. 7. Research Group on Gene-Environment Interactions and Health, University of Leon, Spain
  8. 8. Instituto Nacional de Salud Publica, Morelos, Mexico
  9. 9. Facultad de Medicina, UNAM, Coyoacan, Mexico
  10. 10. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  11. 11. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  12. 12. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
  13. 13. Nikkei Disease Prevention Center, Sao Paulo, Brazil
  14. 14. Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russian Federation
  15. 15. Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States
  16. 16. Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, United States
  17. 17. Medical Informatics Center, Peking University, Peking, China
  18. 18. Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
  19. 19. Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
  20. 20. Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  21. 21. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  22. 22. Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, Riga, Latvia
  23. 23. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom

Source: European Journal of Gastroenterology and Hepatology Published:2019


Abstract

Background Helicobacter pylori (H. pylori) infection is more frequent among men, though the magnitude of the association might be inaccurate due to potential misclassification of lifetime infection and publication bias. Moreover, infection is common, and most studies are cross-sectional. Thus, prevalence ratios (PRs) may be easier to interpret than odds ratios (ORs). Aim The aim of this study was to quantify the association between sex and H. pylori infection using controls from 14 studies from the Stomach Cancer Pooling (StoP) Project. Participants and methods H. pylori infection was defined based on IgG serum antibody titers or multiplex serology. Participants were also classified as infected if gastric atrophy was present, based on histological examination or serum pepsinogen (PG) levels (PG I≤70 and PG I/II ratio≤3). Summary ORs and PRs, adjusted for age, social class and smoking, and corresponding 95% confidence intervals (CIs), were estimated through random-effects meta-analysis. Results Men had significantly higher OR (OR: 1.33, 95% CI: 1.04-1.70) and PR (PR: 1.05, 95% CI: 1.00-1.10) of infection, with stronger associations among hospital-based or older controls. Results were similar when considering the presence of gastric atrophy to define infection status, particularly among participants older than 65 years. Conclusion This collaborative pooled-analysis supports an independent effect of sex on the prevalence of H. pylori infection, while minimizing misclassification of lifetime infection status and publication bias. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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