Relationship between the intake of salt and salted food and the infection of Helicobacter pylori in 40-69 years old local residents in a county with high gastric cancer risk in Anhui Province
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摘要:
目的 了解安徽省某胃癌高发县40~69岁常住居民食盐及腌渍食物摄入与幽门螺杆菌(helicobacter pylori, Hp)感染之间的关系。 方法 2015年7月-2018年8月在安徽省庐江县40~69岁居民中进行问卷调查和Hp血清学检测, 问卷着重调查食盐摄入量及腌渍食物食用频率, 按性别分析Hp感染与危险因素之间的关系, 单因素及多因素Logistic回归模型分析探讨相关影响因素。 结果 调查对象整体Hp感染率为50.07%, 男性居民年龄、体质指数(body mass index, BMI)、婚姻状况、文化程度、工作、劳动强度、经济收入与Hp感染均无关(均有P > 0.05), 女性居民BMI与Hp感染相关(χ2=13.454, P=0.001)。男性居民中, 饮酒是Hp感染的危险因素(OR=1.789, 95% CI:1.188~2.694, P=0.003), 但调整饮酒变量后的多因素分析显示男性食盐摄入量高及腌渍食物摄入频率高对Hp感染均无影响(均有P > 0.05);女性调查对象调整BMI变量后, 食盐摄入量高(≥9 g/d)是女性感染Hp的危险因素(OR=1.462, 95% CI:1.060~2.015, P=0.021), 腌渍食物摄入频率高(≥1次/d)是女性感染Hp的危险因素(OR=1.560, 95% CI:1.021~2.383, P=0.040)。 结论 在安徽省某胃癌高发县, 食盐摄入量高(≥9 g/d)及腌渍食物摄入频率高(≥1次/d)是40~69岁当地女性居民感染Hp的危险因素。 Abstract:Objective The aim of the present study was to investigate the relationship between the intake of salt and salted food and the infection of Helicobacter pylori(Hp) among 40-69 years old local residents in a county with high gastric cancer risk in Anhui province. Methods From July 2015 to August 2018, we conducted a questionnaire and a serological test for Hp among 40-69 years old local residents in Lujiang county, Anhui province. The questionnaire focused on the consumptions of salt and salted food. The relationship between Hp infection and risk factors was analyzed by gender. Univariate and multivariate logistic regression analysis were used to analyze the relevant influencing factors. Results The Hp infection rate of total local residents was 50.07%. Among male subjects, age, body mass index(BMI), marital status, educational level, job, labor intensity and income had no link to Hp infection(allP > 0.05). But among female subjects, BMI was associated with Hp infection(χ2=13.454, P=0.001). Besides, alcohol consumption was a risk factor for Hp infection in male subjects(OR=1.789, 95% CI:1.188-2.694, P=0.003). But, high intake of salt and salted food had no effect on Hp infection after adjustment for alcohol consumption variable in men using multivariate analysis(all P > 0.05). After adjusted for BMI variable among female individuals, high salt intake(≥9 g/day)(OR=1.462, 95% CI:1.060-2.015, P=0.021) and the high salted food intake(≥1 times/day) were risk factors for Hp infection in women(OR=1.560, 95% CI:1.021-2.383, P=0.040). Conclusions In one county with high gastric cancer risk in Anhui province, high salt intake(≥9 g/day) and high salted food intake(≥1 times/day) are risk factors for Hp infection among 40-69 years old female local residents. -
Key words:
- Helicobacter pylori infection /
- High-salt intake /
- Salted food /
- Gastric cancer
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表 1 一般情况描述[n(%)]
Table 1. General description [n(%)]
变量及分类 总数(n=1 392) 男性(n=430) 女性(n=962) χ2/Z值 P值 年龄(岁) 28.649 < 0.001 40~ 454 108(23.79) 346(76.21) 50~ 553 165(29.84) 388(70.16) 60~69 385 157(40.78) 228(59.22) BMI(kg/m2) 15.189 0.006 < 24.0 778 267(34.32) 511(65.68) 24.0~ 452 124(27.43) 328(72.57) ≥28.0 162 39(24.07) 123(75.93) 婚姻状况 0.000 0.993 已婚 1 298 401(30.89) 897(69.11) 未婚/离异/丧偶 94 29(30.85) 65(69.15) 文化程度 155.100 < 0.001 文盲 615 105(17.07) 510(82.73) 小学 433 133(30.72) 300(69.28) 初中及以上 344 192(55.81) 152(44.19) 从事工作 33.036 < 0.001 农民 895 229(25.59) 666(74.41) 非农民 497 201(40.44) 296(59.56) 劳动强度 -0.580 0.562 轻度 155 57(36.77) 98(63.23) 中度 391 102(26.09) 289(73.91) 重度 846 271(32.03) 575(67.97) 经济收入 -2.110 0.035 低 344 97(28.20) 247(71.80) 中 619 183(29.56) 436(70.44) 高 429 150(34.97) 279(65.03) 
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表 2 Hp感染情况描述
Table 2. Description of Hp infection
变量及分类 总数 Hp感染情况n(%) χ2/Z值 P值 Hp阳性 Hp阴性 男性 年龄(岁) 2.821 0.244 40~ 108 57(52.78) 51(47.22) 50~ 165 72(43.64) 93(56.36) 60~69 157 68(43.31) 89(56.69) BMI(kg/m2) 0.490 0.783 < 24.0 267 125(46.82) 142(53.18) 24.0~ 124 56(45.16) 68(54.84) ≥28.0 39 16(41.03) 23(58.97) 高血压 否 249 120(48.19) 129(51.81) 0.154 0.695 是 105 53(50.48) 52(49.52) 婚姻状况 0.438 0.508 已婚 401 182(45.39) 219(54.61) 未婚/离异/丧偶 29 15(51.72) 14(48.28) 文化程度 2.413 0.299 文盲 105 52(49.52) 53(50.48) 小学 133 65(48.87) 68(51.13) 初中及以上 192 80(41.67) 112(58.33) 从事工作 0.909 0.340 农民 229 100(43.67) 129(56.33) 非农民 201 97(48.26) 104(51.74) 劳动强度 -0.418 0.676 轻度 57 27(47.37) 30(52.63) 中度 102 43(42.16) 59(57.84) 重度 271 127(46.86) 144(53.14) 经济收入 -0.808 0.419 低 97 45(46.39) 52(53.61) 中 183 77(42.08) 106(57.92) 高 150 75(50.00) 75(50.00) 消化道疾病用药史 2.299 0.129 无 387 182(47.03) 205(52.97) 有 43 15(34.88) 28(65.12) 近3月消化道症状 2.538 0.468 无 328 152(46.34) 176(53.66) 食欲不振 29 13(44.83) 16(55.17) 上腹部不适 66 27(40.91) 39(59.09) 消瘦贫血 7 5(71.43) 2(28.57) 女性 年龄(岁) 1.355 0.508 40~ 346 185(53.47) 161(46.53) 50~ 388 204(42.58) 184(47.42) 60~69 228 111(48.68) 117(51.32) BMI(kg/m2) 13.454 0.001 < 24.0 511 241(47.16) 270(52.84) 24.0~ 328 197(60.06) 131(39.94) ≥28.0 123 62(50.41) 61(49.59) 高血压 否 571 308(53.94) 263(46.06) 0.572 0.450 是 216 110(50.93) 106(49.07) 婚姻状况 0.003 0.956 已婚 897 466(51.95) 431(48.05) 未婚/离异/丧偶 65 34(52.31) 31(47.69) 文化程度 1.995 0.369 文盲 510 256(50.20) 254(49.80) 小学 300 158(52.67) 142(47.33) 初中及以上 152 86(56.58) 66(43.42) 从事工作 1.001 0.317 农民 666 339(50.90) 327(49.10) 非农民 296 161(54.39) 135(45.61) 劳动强度 -0.693 0.489 轻度 98 49(50.00) 49(50.00) 中度 289 147(50.87) 142(49.13) 重度 575 304(52.87) 271(47.13) 经济收入 -1.446 0.148 低 247 138(55.87) 109(44.13) 中 436 224(51.38) 212(48.62) 高 279 138(49.46) 141(50.54) 消化道疾病用药史 3.390 0.066 无 920 484(52.61) 436(47.39) 有 42 16(38.10) 26(61.90) 近3月消化道症状 5.069 0.167 无 720 388(53.89) 332(46.11) 食欲不振 53 27(50.94) 26(49.06) 上腹部不适 165 73(44.24) 92(55.76) 消瘦贫血 24 12(50.00) 12(50.00)
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表 3 生活方式、食盐及腌渍食物摄入与Hp感染关系的单因素分析
Table 3. Univariate analysis of the relationship between lifestyle, the intake of salt and salted food and Hp infection
变量及分类 例数(n) Hp(阳性/阴性) OR(95% CI)值 P值 男性 吸烟 否 188 78/110 1.000 是 242 119/123 1.364(0.929~2.004) 0.113 饮酒 否 159 58/101 1.000 是 271 139/132 1.834(1.228~2.739) 0.003 饮茶 否 115 45/70 1.000 是 315 152/163 1.451(0.939~2.241) 0.094 饮用水来源 井水/塘水 157 70/87 1.000 自来水/桶装水 273 127/146 1.081(0.729~1.604) 0.698 喜烫饮烫食 否 330 150/180 1.000 是 100 47/53 1.064(0.680~1.666) 0.786 食盐摄入量(g/d) < 6 70 43/67 1.000 6~ 140 71/69 1.603(0.966~2.660) 0.068 ≥9 180 83/97 1.333(0.823~2.159) 0.242 腌渍食物摄入频率 ≤1次/周 47 17/30 1.000 < 1次/d 145 67/78 1.516(0.769~2.988) 0.230 1~次/d 238 113/125 1.595(0.835~3.047) 0.157 女性 吸烟 否 949 494/455 1.000 是 13 6/7 0.789(0.263~2.367) 0.673 饮酒 否 816 428/388 1.000 是 146 72/74 0.882(0.620~1.255) 0.485 饮茶 否 473 243/230 1.000 是 489 257/232 1.048(0.814~1.350) 0.714 饮用水来源 井水/塘水 361 185/176 1.000 自来水/桶装水 601 315/286 1.048(0.807~1.361) 0.726 喜烫饮烫食 否 616 321/295 1.000 是 346 179/167 0.985(0.757~1.282) 0.911 食盐摄入量(g/d) < 6 261 127/134 1.000 6~ 318 152/166 0.966(0.696~1.341) 0.837 ≥9 383 221/162 1.439(1.049~1.975) 0.024 腌渍食物摄入频率 ≤1次/周 109 44/65 1.000 < 1次/d 289 151/138 1.616(1.034~2.527) 0.035 1~次/d 564 305/259 1.740(1.147~2.640) 0.009
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表 4 不同性别食盐及腌渍食物摄入与Hp感染的多因素分析
Table 4. Multivariate analysis of salt, salted food intake and Hp infection in different gender subjects
变量及分类 β Wald χ2值 P值 OR(95% CI)值 男性a 饮酒 否 - - - - 是 0.582 7.757 0.005 1.789(1.188~2.694) 食盐摄入量(g/d) < 6 - - - - 6~ 0.432 2.701 0.100 1.540(0.920~2.577) ≥6 0.172 0.467 0.494 1.188(0.725~1.945) 腌渍食物摄入频率 ≤1次/周 - - - - < 1次/d 0.308 0.764 0.382 1.361(0.682~2.714) ≥1次/d 0.355 1.115 0.291 1.426(0.738~2.756) 女性b BMI(kg/m2) < 24.0 - - - - 24.0~ 0.524 13.013 0.000 1.689(1.270~2.245) ≥28.0 0.149 0.541 0.462 1.161(0.780~1.727) 食盐摄入量(g/d) < 6 - - - - 6~ -0.014 0.007 0.935 0.986(0.708~1.374) ≥6 0.380 5.359 0.021 1.462(1.060~2.015) 腌渍食物摄入频率 ≤1次/周 - - - - < 1次/d 0.457 3.930 0.047 1.579(1.005~2.481) ≥1次/d 0.444 4.225 0.040 1.560(1.021~2.383) 注:a调整饮酒; b调整BMI。
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