PDF | https://doi.org/10.46613/congastro2023-198
This work is licensed under CC BY 4.0
Uribe J1, Fuentes I1, Martinez F1, Silva F1, Bustamante M1, Lustig N1, Maquilón S1, Vargas J1, Espino A1, Riquelme A1, Shah S2, Florenzano P1, Latorre G1
1Pontificia Universidad Católica de Chile, Santiago, Chile
2University of California, San Diego, California, Estados Unidos (EEUU)
Background: Chronic atrophic gastritis (CAG) is a progressive inflammatory condition of the gastric mucosa, caused by Helicobacter pylori (Hp) infection and autoimmune gastritis (AIG), which is characterized by atrophy due to the loss of gastric glandular cells. Parietal cell atrophy leads to hypochlorhydria or achlorhydria. Through this mechanism CAG may lead to impaired absorption of calcium and vitamin-D, potentially leading to decrease bone density (DBD).
Aim: Investigate and compare the frequency of DBD in patients with CAG (cases) of any origin, contrasted with healthy controls without CAG (Operative Link for Gastritis-Assessment (OLGA) stage 0).
Methods: Case-control study to compare DBD in patients with CAG (cases) to patients with OLGA 0 (controls). Cases included either Hp-related CAG or AIG. Adult patients with availability of dual-energy X-ray absorptiometry (DEXA) scans and esophagogastroduodenoscopy with gastric biopsies by Sydney protocol were included. The primary outcome was DBD as defined by osteopenia (T-score–2.5 to -1) and osteoporosis (T-score<-2.5). We performed logistic regression adjusted for age and sex to quantify the association between DBD.
Results: 139 patients were included. The CAG group comprised 74 patients (97% female; mean age 66 years-old), 44 of whom (59%) had Hp infection and 41% (n=30) AIG. Sixty-five patients were OLGA 0 (control group) (95% female; mean age 66 years-old). Mineral density, T-score and Z-score by group are described in Table 1. Logistic-regression revealed that DBD was more commonly in patients over 50 years-old with CAG contrasted to OLGA 0 patients (Odds-Ratio2.3;95%CI:1.02-4.9). No significant differences were observed among Hp related CAG and AIG.
Conclusion: DBD was more common in patients with CAG of any origin, particularly in patients over 50 years-old. These results emphasize the importance of early screening and management of bone health in patients with CAG to mitigate potential complications associated with impaired bone mass.
