Atrophic Gastritis as a Risk Factor for Bone Loss in Premenopausal Women in Their 40s: A Retrospective Cohort Study
This study assessed the effects of atrophic gastritis on bone mineral density (BMD) in premenopausal women in their 40s. We performed a retrospective analysis of medical records of premenopausal women in their 40s who underwent a health checkup, esophagogastroduodenoscopy, and bone densitometry at least thrice, 24 months apart, between January 2006 and December 2016. Based on first-visit esophagogastroduodenoscopy results, patients were divided into atrophic and non-atrophic gastritis groups; BMD changes over time were analyzed. Patients were further divided into subgroups depending on atrophic gastritis persistence; differences and absolute changes in BMD were assessed. BMD in both groups exhibited group-by-time interaction (p < 0.001). After adjusting for confounding factors, the mean BMD was significantly different at the 24-month and the 48-month follow-up (p = 0.049, p < 0.001, respectively). Subgroup analysis after adjusting for confounding factors showed a mean BMD of 1.128 and 1.104 at baseline, 1.110 and 1.100 at the 24-month follow-up, and 1.106 and 1.065 at the 48-month follow-up for persistent atrophic and non-atrophic gastritis groups, respectively. The difference between mean BMD was not significant at baseline (p = 0.171), but was significant at the 24-month and 48-month follow-ups (p = 0.044 and p < 0.001, respectively). Absolute changes in BMD over 48 months were − 0.010 and − 0.051 for the two subgroups, which was significantly different (p < 0.001). Atrophic gastritis reduces BMD in premenopausal women in their 40s. Patients with atrophic gastritis exhibited lower BMD than patients without, and patients with persistent atrophic gastritis exhibited a greater decrease in BMD.
KeywordsAtrophic gastritis Bone mineral density Hypochlorhydria Premenopause Woman
ASK and HJK conceived and designed the research; ASK and HJK analyzed the data; ASK and HJK wrote the paper.
Compliance with Ethical Standards
Conflict of interest
A-Sol Kim and Hae-Jin Ko declare that they have no conflicts of interest regarding the publication of this article.
Human and Animal Rights and Informed Consent
This study was approved by the institutional review board at Kyungpook National University Chilgok Hospital, which waived the requirement for informed consent as this was a retrospective analysis. This study was performed in accordance with the Ethical Standards as laid down in the 1964 Declaration of Helsinki and its later amendments.
- 12.Schinke T, Schilling AF, Baranowsky A, Seitz S, Marshall RP, Linn T, Blaeker M, Huebner AK, Schulz A, Simon R, Gebauer M, Priemel M, Kornak U, Perkovic S, Barvencik F, Beil FT, Del Fattore A, Frattini A, Streichert T, Pueschel K, Villa A, Debatin KM, Rueger JM, Teti A, Zustin J, Sauter G, Amling M (2009) Impaired gastric acidification negatively affects calcium homeostasis and bone mass. Nat Med 15(6):674–681. https://doi.org/10.1038/nm.1963 CrossRefGoogle Scholar
- 23.Abe T, Kodama M, Murakami K, Matsunari O, Mizukami K, Inoue K, Uchida M, Okimoto T, Fujioka T, Uchida T, Moriyama M, Yamaoka Y (2011) Impact of Helicobacter pylori CagA diversity on gastric mucosal damage: an immunohistochemical study of East-Asian-type CagA. J Gastroenterol Hepatol 26(4):688–693. https://doi.org/10.1111/j.1440-1746.2010.06565.x CrossRefGoogle Scholar