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Atrophic Gastritis as a Risk Factor for Bone Loss in Premenopausal Women in Their 40s: A Retrospective Cohort Study

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Abstract

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.

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References

  1. Kanis JA, Gluer CC (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int 11(3):192–202

    Article  CAS  PubMed  Google Scholar 

  2. Hansen MA, Overgaard K, Riis BJ, Christiansen C (1991) Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study. BMJ 303(6808):961–964

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Gordon CM, Zemel BS, Wren TA, Leonard MB, Bachrach LK, Rauch F, Gilsanz V, Rosen CJ, Winer KK (2017) The determinants of peak bone mass. J Pediatr 180:261–269. https://doi.org/10.1016/j.jpeds.2016.09.056

    Article  PubMed  Google Scholar 

  4. Rugge M, Correa P, Dixon MF, Fiocca R, Hattori T, Lechago J, Leandro G, Price AB, Sipponen P, Solcia E, Watanabe H, Genta RM (2002) Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther 16(7):1249–1259

    Article  CAS  PubMed  Google Scholar 

  5. Bo-Linn GW, Davis GR, Buddrus DJ, Morawski SG, Santa Ana C, Fordtran JS (1984) An evaluation of the importance of gastric acid secretion in the absorption of dietary calcium. J Clin Invest 73(3):640–647. https://doi.org/10.1172/JCI111254

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sipponen P, Harkonen M (2010) Hypochlorhydric stomach: a risk condition for calcium malabsorption and osteoporosis? Scand J Gastroenterol 45(2):133–138. https://doi.org/10.3109/00365520903434117

    Article  CAS  PubMed  Google Scholar 

  7. Recker RR (1985) Calcium absorption and achlorhydria. N Engl J Med 313(2):70–73. https://doi.org/10.1056/NEJM198507113130202

    Article  CAS  PubMed  Google Scholar 

  8. Eastell R, Vieira NE, Yergey AL, Wahner HW, Silverstein MN, Kumar R, RIGGS BL (1992) Pernicious anaemia as a risk factor for osteoporosis. Clin Sci 82(6):681–685

    Article  CAS  PubMed  Google Scholar 

  9. Kakehasi AM, Mendes CM, Coelho LG, Castro LP, Barbosa AJ (2007) The presence of Helicobacter pylori in postmenopausal women is not a factor to the decrease of bone mineral density. Arq Gastroenterol 44(3):266–270

    Article  PubMed  Google Scholar 

  10. Gunzerath L, Faden V, Zakhari S, Warren K (2004) National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. Alcoholism 28(6):829–847

    Article  PubMed  Google Scholar 

  11. Kimura K, Takemoto T (1969) An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1(03):87–97

    Article  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  13. Yu EW, Bauer SR, Bain PA, Bauer DC (2011) Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies. Am J Med 124(6):519–526. https://doi.org/10.1016/j.amjmed.2011.01.007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Asaoka D, Nagahara A, Hojo M, Sasaki H, Shimada Y, Yoshizawa T, Osada T, Watanabe S (2014) The relationship between H. pylori infection and osteoporosis in Japan. Gastroenterol Res Pract 2014:340765. https://doi.org/10.1155/2014/340765

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kim HW, Kim YH, Han K, Nam GE, Kim GS, Han BD, Lee A, Ahn JY, Ko BJ (2014) Atrophic gastritis: a related factor for osteoporosis in elderly women. PLoS ONE 9(7):e101852. https://doi.org/10.1371/journal.pone.0101852

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Knox TA, Kassarjian Z, Dawson-Hughes B, Golner BB, Dallal GE, Arora S, Russell RM (1991) Calcium absorption in elderly subjects on high- and low-fiber diets: effect of gastric acidity. Am J Clin Nutr 53(6):1480–1486

    Article  CAS  PubMed  Google Scholar 

  17. Aasarod KM, Mosti MP, Stunes AK, Reseland JE, Basso T, Syversen U, Fossmark R (2016) Impaired skeletal health in patients with chronic atrophic gastritis. Scand J Gastroenterol 51(7):774–781. https://doi.org/10.3109/00365521.2016.1141317

    Article  CAS  PubMed  Google Scholar 

  18. Wang J, Xu L, Shi R, Huang X, Li SW, Huang Z, Zhang G (2011) Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Digestion 83(4):253–260. https://doi.org/10.1159/000280318

    Article  PubMed  Google Scholar 

  19. Rokkas T, Pistiolas D, Sechopoulos P, Robotis I, Margantinis G (2007) The long-term impact of Helicobacter pylori eradication on gastric histology: a systematic review and meta-analysis. Helicobacter 2(12 Suppl):32–38. https://doi.org/10.1111/j.1523-5378.2007.00563.x

    Article  Google Scholar 

  20. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG (1991) Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 338(8776):1175–1176

    Article  CAS  Google Scholar 

  21. Graham DY, Osato MS, Olson CA, Zhang J, Figura N (1998) Effect of H. pylori infection and CagA status on leukocyte counts and liver function tests: extra-gastric manifestations of H. pylori infection. Helicobacter 3(3):174–178

    Article  CAS  PubMed  Google Scholar 

  22. Pacifici R (1998) Cytokines, estrogen, and postmenopausal osteoporosis—the second decade. Endocrinology 139(6):2659–2661. https://doi.org/10.1210/endo.139.6.6087

    Article  CAS  PubMed  Google 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

    Article  PubMed  Google Scholar 

  24. Quach DT, Le HM, Hiyama T, Nguyen OT, Nguyen TS, Uemura N (2013) Relationship between endoscopic and histologic gastric atrophy and intestinal metaplasia. Helicobacter 18(2):151–157. https://doi.org/10.1111/hel.12027

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Family Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu, 41404, South Korea

    A-Sol Kim

  2. Department of Family Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 41944, South Korea

    Hae-Jin Ko

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  1. A-Sol Kim
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Contributions

ASK and HJK conceived and designed the research; ASK and HJK analyzed the data; ASK and HJK wrote the paper.

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Correspondence to Hae-Jin Ko.

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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.

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Kim, AS., Ko, HJ. Atrophic Gastritis as a Risk Factor for Bone Loss in Premenopausal Women in Their 40s: A Retrospective Cohort Study. Calcif Tissue Int 104, 34–41 (2019). https://doi.org/10.1007/s00223-018-0473-6

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  • DOI: https://doi.org/10.1007/s00223-018-0473-6

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