음주가 한국인 성인의 혈청 항헬리코박터 항체 전환에 미치는 영향에 대한 연구
Effect of Alcohol Consumption on Seroconversion in Helicobacter pylori-Seronegative Koreans
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목적: 헬리코박터 파일로리 균에 대한 혈청전환의 위험성은 감염된 가족과 거주하거나 상부위장관 내시경 검사를 받으면 상승한다. 우리나라에서는 음주가 혈청전환의 위험요인으로 알려져 있으나, 외국에서는 이와 상반된 연관성을 보인다. 이에 본 연구에서는 한국인에서 혈청전환을 유발하는위험 요인을 분석하고, 음주량이 혈청전환에 미치는 영향력을 조사하였다. 방법: 혈청 항헬리코박터 파일로리 항체 검사에서 음성을보인 한국인 성인 중 매년 혈청항체에 대한 추적 검사를 하면서 혈청 펩시노겐 검사와 상부위장관 내시경 검사를 함께받은 사람을 대상으로 하였다. 위 절제술이나 제균 치료를받은 사람은 대상에서 제외하였다. 심한 음주자는 일주일에15잔 이상을 마시는 남자와 8잔 이상을 마시는 여자로 정의하였다. 결과: 항체 음성자 267명 중 26명(9.7%)이 혈청전환을 보였으며, 평균 추적 기간은 39.0 ± 19.1개월이었다. 혈청전환율은 음주량(p = 0.001), 비스테로이드성항염증제 복용력(p = 0.015), 높은 체질량지수(p = 0.033), 긴 추적 기간(p = 0.038), 많은 추적 검사 횟수(p = 0.004)와 비례해서 증가하였다. 이중에서 심한 음주자(OR 6.754, 95% CI 1.892-24.102, p = 0.003) 와 보통 음주자(OR 4.360, 95% CI 1.130-16.826, p = 0.033)만이 혈청전환의 독립적인 위험 인자로 밝혀졌다. 추적 검사시의 혈청 펩시노겐 II 수치는 혈청전환자(12.0 ± 7.8 ng/mL) 가 대조군(9.1 ± 5.3 ng/mL)에 비해서 높았다(p = 0.038). 결론: 한국인에서 음주는 혈청전환과 연관된 주요 위험인자이다. 이는 음주를 줄이고 비위생적 음주 습관을 개선하는 것이 한국인 성인들 사이에서 헬리코박터 파일로리균의전염을 예방하는데 도움이 될 수 있다는 것을 시사한다.
Abstract
Background/Aims: Helicobacter pylori (H. pylori) seroconversion may develop in seronegative adults. Although a positive correlation has been reported between alcohol consumption and seroconversion in Korea, an inverse correlation has been reported in other countries. The aim of this study was to investigate the risk factors for seroconversion in Korea. Methods: We included Korean adults who were H. pylori-negative negative in their annual serum immunoglobulin G and pepsinogen assays, and in upper gastrointestinal endoscopy. Subjects with a history of H. pylori eradication or gastrectomy were excluded. The criteria for heavy alcohol consumption were ≥ 15 drinks/week for males and ≥ 8 drinks/week for females. Results: Of 267 H. pylori-seronegative subjects, 26 (9.7%) exhibited seroconversion at a mean follow-up time of 39.0 ± 19.1 months. Seroconversion was positively correlated with alcohol consumption (p = 0.001), nonsteroidal anti-inflammatory drug use (p = 0.015), a higher body mass index (p = 0.033), a longer follow-up period (p = 0.038), and a greater number of follow-up tests (p = 0.004). Heavy drinking (odds ratio 6.754, 95% confidence interval 1.892-24.102, p = 0.003) and social drinking (odds ratio 4.360, 95% confidence interval 1.130-16.826, p = 0.033) were independent risk factors for seroconversion. During follow-up, subjects with seroconversion had higher serum levels of pepsinogen II (12.0 ± 7.8 ng/mL) than others (9.1 ± 5.3 ng/mL) (p = 0.038). Conclusions: Alcohol consumption is related to seroconversion in Koreans. H. pylori transmission might be prevented by reducing alcohol consumption and controlling drinking habits.
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