International Journal of Epidemiology, Vol 26, 880-887, Copyright © 1997 by International Epidemiological Association
LJ Murray, EE McCrum, AE Evans and KB Bamford
BACKGROUND: Despite the widespread prevalence and serious clinical sequelae
of infection with Helicobacter pylori, there have been few large
population-based studies, using randomly selected subjects, examining the
epidemiology of this infection. AIM: To examine the distribution and
determinants of H. pylori infection in a developed country. SUBJECTS AND
SETTING: Overall 4742 subjects, aged 12-64, from Northern Ireland were
randomly selected. METHODS: Helicobacter pylori specific IgG antibodies
were measured by enzyme linked immunosorbent assay, using an acid-glycine
extract antigen, in stored serum from subjects who had participated in
three linked population-based surveys of cardiovascular risk factors
performed in 1986 and 1987. RESULTS: The overall prevalence of H. pylori
infection was 50.5%. Prevalence increased with age from 23.4% in 12-14 year
olds to 72.7% in 60-64 year olds: chi 2 for trend 518, P < 10(-4). In
subjects aged > or = 25, infection was more common in males (60.9%) than
females (55.2%): chi 2 = 9.53, P < 0.01. This relation remained
significant after adjusting for age, and measures of socioeconomic class:
odds ratio (OR) for infection, male versus female was 1.19 (95% confidence
interval [CI]: 1.02-1.40). Infection was associated with social class: the
adjusted OR of infection in subjects from manual social classes relative to
those from non-manual classes was 1.7 (95% CI: 1.47-1.98). Infection was
significantly more common in current smokers and ex-smokers than in
subjects who had never smoked: adjusted OR for infection, ex-smokers versus
never smoked was 1.22 (95% CI: 1.01-1.49); for smokers of > or = 20/day
versus never smoked OR = 1.33 (95% CI: 1.05-1.67). Infection was not
associated with height in adult males but mean height in infected women was
lower than in uninfected women after adjusting for age and socioeconomic
status: difference in mean height (SE), -0.85 cm (0.32), P < 0.01. There
was no demonstrable relationship between H. pylori infection and current
alcohol intake. CONCLUSIONS: This study demonstrated a high prevalence of
infection in a population from a developed country. Previously reported
associations between H. pylori infection, age, sex, social class, and
reduced height in females were confirmed and smoking was identified as a
possible risk factor for H. pylori infection.
ARTICLES
Epidemiology of Helicobacter pylori infection among 4742 randomly selected subjects from Northern Ireland
Department of Epidemiology and Public Health, Queen's University of Belfast, Royal Group of Hospitals, Northern Ireland.
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