Association between Chronic Atrophic Gastritis and Bone Mineral Density among Women Older than 40 Years of Age in Korea
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Background: Chronic atrophic gastritis causes hypochlorhydria, hypergastrinemia, and malabsorption of nutrients, leading to lower bone mineral density. The few studies that investigated the association between chronic atrophic gastritis and bone mineral density have reported inconsistent findings. As such, the present study assessed the association between chronic atrophic gastritis and bone mineral density among a large sample of women >40 years of age in Korea. Methods: Data from 8,748 women >40 years of age who underwent esophagogastroduodenoscopy and bone densitometry were analyzed. Chronic atrophic gastritis was diagnosed using esophagogastroduodenoscopy. Bone mineral density of the lumbar vertebrae (L), femur neck, and femur total, measured using dual-energy X-ray absorptiometry, were the primary outcome variables. Low bone mineral density, which could be diagnosed as osteoporosis or osteopenia, was defined and analyzed as a secondary outcome. Linear regression was used to calculate adjusted mean values of bone mineral density. The association between low bone mineral density and chronic atrophic gastritis was analyzed using multiple logistic regression. Results: The adjusted mean bone mineral density for L1–L4 was 1.063±0.003, femur neck (0.826±0.002), and femur total (0.890±0.002) were significantly lower in patients with chronic atrophic gastritis than others (1.073±0.002, 0.836±0.001, 0.898±0.002, respectively; all P<0.01). Women with chronic atrophic gastritis exhibited an increased likelihood for osteopenia or osteoporosis, even after adjusting for age and other confounding factors (odds ratio, 1.25; 95% confidence interval, 1.13–1.40; P<0.01). However, subgroup analysis revealed statistical significance only in postmenopausal women (odds ratio, 1.27; P<0.001). Conclusion: Chronic atrophic gastritis was associated with lower bone mineral density and a higher risk for osteopenia or osteoporosis among postmenopausal women.
Abstract
Background: Chronic atrophic gastritis causes hypochlorhydria, hypergastrinemia, and malabsorption of nutrients, leading to lower bone mineral density. The few studies that investigated the association between chronic atrophic gastritis and bone mineral density have reported inconsistent findings. As such, the present study assessed the association between chronic atrophic gastritis and bone mineral density among a large sample of women >40 years of age in Korea. Methods: Data from 8,748 women >40 years of age who underwent esophagogastroduodenoscopy and bone densitometry were analyzed. Chronic atrophic gastritis was diagnosed using esophagogastroduodenoscopy. Bone mineral density of the lumbar vertebrae (L), femur neck, and femur total, measured using dual-energy X-ray absorptiometry, were the primary outcome variables. Low bone mineral density, which could be diagnosed as osteoporosis or osteopenia, was defined and analyzed as a secondary outcome. Linear regression was used to calculate adjusted mean values of bone mineral density. The association between low bone mineral density and chronic atrophic gastritis was analyzed using multiple logistic regression. Results: The adjusted mean bone mineral density for L1–L4 was 1.063±0.003, femur neck (0.826±0.002), and femur total (0.890±0.002) were significantly lower in patients with chronic atrophic gastritis than others (1.073±0.002, 0.836±0.001, 0.898±0.002, respectively; all P<0.01). Women with chronic atrophic gastritis exhibited an increased likelihood for osteopenia or osteoporosis, even after adjusting for age and other confounding factors (odds ratio, 1.25; 95% confidence interval, 1.13–1.40; P<0.01). However, subgroup analysis revealed statistical significance only in postmenopausal women (odds ratio, 1.27; P<0.001). Conclusion: Chronic atrophic gastritis was associated with lower bone mineral density and a higher risk for osteopenia or osteoporosis among postmenopausal women.
참고문헌 (30)
- Shah SC, "AGA clinical practice update on the diagnosis and management of atrophic gastritis : expert review", Gastroenterology, 161, pp.1325~1332 (2021)
- Raza M, "Atrophic gastritis" (2021), StatPearls
- Lin S, "Association of dietary patterns and endoscopic gastric mucosal atrophy in an adult Chinese population", Sci Rep, 9, pp.16567~ (2019)
- Song JH, "High salt intake is associated with atrophic gastritis with intestinal metaplasia", Cancer Epidemiol Biomarkers Prev, 26, pp.1133~1138 (2017)
- Gluckman CR, "Chronic atrophic gastritis : don’t miss these nutritional deficiencies", Pract Gastroenterol, 44, pp.34~39 (2020)
- Cavalcoli F, "Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis : a review", World J Gastroenterol, 23, pp.563~572 (2017)
- Recker RR, "Calcium absorption and achlorhydria", N Engl J Med, 313, pp.70~73 (1985)
- Massironi S, "Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis : a prospective study", BMC Gastroenterol, 18, pp.172~ (2018)
- Johnell O, "An estimate of the worldwide prevalence and disability associated with osteoporotic fractures", Osteoporos Int, 17, pp.1726~1733 (2006)
- Finkelstein JS, "Bone mineral density changes during the menopause transition in a multiethnic cohort of women", J Clin Endocrinol Metab, 93, pp.861~868 (2008)
- Pouresmaeili F, "A comprehensive overview on osteoporosis and its risk factors", Ther Clin Risk Manag, 14, pp.2029~2049 (2018)
- Kim HW, "Atrophic gastritis : a related factor for osteoporosis in elderly women", PLoS One, 9, pp.e101852~ (2014)
- Kim AS, "Atrophic gastritis as a risk factor for bone loss in premenopausal women in their 40s : a retrospective cohort study", Calcif Tissue Int, 104, pp.34~41 (2019)
- Aasarod KM, "Impaired skeletal health in patients with chronic atrophic gastritis", Scand J Gastroenterol, 51, pp.774~781 (2016)
- Kakehasi AM, "Chronic gastritis and bone mineral density in women", Dig Dis Sci, 54, pp.819~824 (2009)
- Lee JY, "Correlations among endoscopic, histologic and serologic diagnoses for the assessment of atrophic gastritis", J Cancer Prev, 19, pp.47~55 (2014)
- Yoo SH, "Risk of osteoporosis after gastrectomy in long-term gastric cancer survivors", Gastric Cancer, 21, pp.720~727 (2018)
- Haastrup PF, "Side effects of long-term proton pump inhibitor use : a review", Basic Clin Pharmacol Toxicol, 123, pp.114~121 (2018)
- Rude RK, "Skeletal and hormonal effects of magnesium deficiency", J Am Coll Nutr, 28, pp.131~141 (2009)
- Schwartz R, "Influence of magnesium depletion on matrixinduced endochondral bone formation", Calcif Tissue Int, 29, pp.15~20 (1979)
- Rude RK, "Magnesium deficiency and osteoporosis : animal and human observations", J Nutr Biochem, 15, pp.710~716 (2004)
- Pironi L, "The complex relationship between magnesium and serum parathyroid hormone : a study in patients with chronic intestinal failure", Magnes Res, 22, pp.37~43 (2009)
- Gray RW, "25-Hydroxycholecalciferol-1-hydroxylase : subcellular location and properties", J Biol Chem, 247, pp.7528~7532 (1972)
- Biosse-Duplan M, "Histamine promotes osteoclastogenesis through the differential expression of histamine receptors on osteoclasts and osteoblasts", Am J Pathol, 174, pp.1426~1434 (2009)
- Abrahamsen B, "Proton pump inhibitor use and fracture risk : effect modification by histamine H1 receptor blockade : observational case-control study using National Prescription Data", Bone, 57, pp.269~271 (2013)
- Kang HS, "Atrophic gastritis : pathophysiology and etiology", Korean J Helicobacter Up Gastrointest Res, 13, pp.1~5 (2013)
- Ferrari SL, "Interactions of interleukin-6 promoter polymorphisms with dietary and lifestyle factors and their association with bone mass in men and women from the Framingham Osteoporosis Study", J Bone Miner Res, 19, pp.552~559 (2004)
- Amarasekara DS, "Bone loss triggered by the cytokine network in inflammatory autoimmune diseases", J Immunol Res, 2015, pp.832127~ (2015)
- Eshmuratov A, "The correlation of endoscopic and histological diagnosis of gastric atrophy", Dig Dis Sci, 55, pp.1364~1375 (2010)
- Ahn SY, "Endoscopic diagnosis of open-type atrophic gastritis is related to the histological diagnosis of intestinal metaplasia and Cdx2 expression", Dig Dis Sci, 56, pp.1119~1126 (2011)
