Smoking ups risk of gastric intestinal metaplasia

Cigarette smoking may increase the risk of gastric intestinal metaplasia (GIM), and such risk remains significantly elevated among former smokers until 15 years post-cessation, reveals a recent study.

To determine whether various dimensions of smoking raise the risk of GIM, the authors compared data from 385 GIM patients and 1,577 healthy controls, who were recruited into a cross-sectional study at the Michael E. DeBakey VA Medical Center in Houston, Texas, US.

Participants completed standardized questionnaires and underwent an endoscopy with gastric mapping biopsies. GIM patients included those with intestinal metaplasia on any noncardiac gastric biopsy. The authors then used multivariable logistic regression models to calculate odds ratios (ORs) and associated 95 percent confidence intervals (CIs).

Current smokers had twofold increased risk for GIM compared with never smokers (OR, 2.05, 95 percent CI, 1.47‒2.85). Among ever smokers, increasing duration (p_trend=0.004) and total dose (p_trend=0.01) significantly correlated with a higher risk of GIM. The risk for GIM decreased over time among former smokers and was no different to never smokers only after 15 years smoking cessation.

Cases with GIM were more likely to have Helicobacter pylori infection relative to controls (53.2 percent vs 21.7 percent), but the smoking effect on gastric intestinal metaplasia did not differ by H. pylori infection status.