Helicobacter Pylori Infection is Associated With Reduced Risk of Barrett’s Esophagus: An Analysis of the Barrett’s and Esophageal Adenocarcinoma Consortium

Zhensheng Wang, Nicholas J Shaheen, David C. Whiteman, Lesley A. Anderson, Thomas L. Vaughan, Douglas A Corley, Hashem B El-Serag, Joel Rubenstein, Aaron P. Thrift

Research output: Contribution to journalArticle

16 Citations (Scopus)
236 Downloads (Pure)

Abstract

OBJECTIVES: Epidemiological studies of Helicobacter pylori infection and risk of Barrett’s esophagus (BE) have reported conflicting results. We examined the association between H. pylori infection and BE and sought to determine whether the association is mediated by gastroesophageal reflux disease (GERD) and to identify potential effect modifiers.

METHODS: We used individual level data from 1308 patients with BE (cases), 1388 population-based controls, and 1775 GERD controls in the Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON). We estimated study-specific odds ratios (ORs) and 95% CIs using multivariable logistic regression models and obtained summary risk estimates using a random effects meta-analytic approach. We examined potential effect modification by waist-to-hip ratio (WHR), body mass index (BMI), and smoking status by conducting stratified analyses.

RESULTS: For comparisons with population-based controls, H. pylori infection was inversely associated with the risk of BE (adjusted OR=0.44, 95% CI=0.36-0.55), with no evidence of between-study heterogeneity (I2=0%). A stronger inverse association between H. pylori and BE was observed among individuals with the CagA positive strain (P for interaction=0.017). We found no evidence of interaction between WHR, BMI, smoking status and H. pylori infection on the risk of BE. There was no association between H. pylori infection and BE for comparisons with GERD controls (OR=0.96, 95% CI=0.67-1.37; I2=48%).

CONCLUSIONS: This study provides the strongest evidence yet that H. pylori infection is strongly inversely associated with BE. This effect is probably mediated by a decrease in GERD in infected patients, since the protective effect disappears in patients with GERD symptoms.
Original languageEnglish
JournalAmerican Journal of Gastroenterology
DOIs
Publication statusPublished - 08 Jun 2018

Fingerprint Dive into the research topics of 'Helicobacter Pylori Infection is Associated With Reduced Risk of Barrett’s Esophagus: An Analysis of the Barrett’s and Esophageal Adenocarcinoma Consortium'. Together they form a unique fingerprint.

  • Cite this