Inverse relations between Helicobacter pylori infection and risk of esophageal precancerous lesions in drinkers and peanut consumption

BACKGROUND Helicobacter pylori(H. pylori) is a Gram-negative bacterium found in the upper digestive tract. Although H. pylori infection is an identified risk factor for gastric cancer, its role in esophageal squamous cell carcinoma(ESCC) remains a topic of much debate.AIM To evaluate the association between H. pylori infection and the risk of precancerous lesions of ESCC, and further explore the association between dietary factors and the risk of H. pylori infection.METHODS Two hundred patients with esophageal precancerous lesions(EPL) aged 63.01 ± 6.08 years and 200 healthy controls aged 62.85 ± 6.03 years were included in this case-control study. Epidemiological data and qualitative food frequency data were investigated. Enzyme-linked immunosorbent assay measuring serum immunoglobulin G antibodies was used to determine H. pylori seropositivity. An unconditional logistic regression model was used to assess the association between H. pylori infection and EPL risk dichotomized by gender, age, and the use of tobacco and alcohol, as well as the association between dietary factors and the risk of H. pylori infection.RESULTS A total of 47(23.5%) EPL cases and 58(29.0%) healthy controls had positive H. pylori infection. An inverse relation between H. pylori infection and the risk of EPL was found in the group of drinkers after adjustment for covariates [odds ratio(OR) = 0.32, 95% confidence interval(95%CI): 0.11-0.95]. Additionally, peanut intake was significantly associated with a decreased risk of H. pylori infection(OR = 0.39, 95%CI: 0.20-0.74).CONCLUSION Our study suggested that H. pylori infection may decrease the risk of EPL for drinkers in a rural adult Chinese population, and the consumption of peanut may reduce the risk of H. pylori infection. These findings should be framed as preliminary evidence, and further studies are required to address whether the mechanisms are related to the localization of lesions and alcohol consumption.

Prevalence and risk factors of stroke in China:a national serial cross-sectional study from 2003 to 2018

Stroke imposes a substantial burden worldwide.With the rapid economic and lifestyle transition in China,trends of the prevalence of stroke across different geographic regions in China remain largely unknown.Capitalizing on the data in the National Health Services Surveys(NHSS),we assessed the prevalence and risk factors of stroke in China from 2003 to 2018.In this study,data from 2003,2008,2013,and 2018 NHSS were collected.Stroke cases were based on participants’self-report of a previous diagnosis by clinicians.We estimated the trends of stroke prevalence for the overall population and subgroups by age,sex,and socioeconomic factors,then compared across different geographic regions.We applied multivariable logistic regression to assess associations between stroke and risk factors.The number of participants aged 15 years or older were 154,077,146,231,230,067,and 212,318 in 2003,2008,2013,and 2018,respectively,among whom,1435,1996,3781,and 6069 were stroke patients.The age and sex standardized prevalence per 100,000 individuals was 879 in 2003,1100 in 2008,1098 in 2013,and 1613 in 2018.Prevalence per 100,000 individuals in rural areas increased from 669 in 2003 to 1898 in 2018,while urban areas had a stable trend from 1261 in 2003 to 1365 in 2018.Across geographic regions,the central region consistently had the highest prevalence,but the western region has an alarmingly increasing trend from 623/100,000 in 2003 to 1898/100,000 in 2018(Ptrend<0.001),surpassing the eastern region in 2013.Advanced age,male sex,rural area,central region,hypertension,diabetes,depression,low education and income level,retirement or unemployment,excessive physical activity,and unimproved sanitation facilities were significantly associated with stroke.In conclusion,the increasing prevalence of stroke in China was primarily driven by economically underdeveloped regions.It is important to develop targeted prevention programs in underdeveloped regions.Besides traditional risk factors,more attention should be paid to nontraditional risk factors to improve the prevention of stroke.