Prevalence and risk factors of Helicobacter pylori infection in Korea: Nationwide multicenter study over 13 years

Abstract

BackgroundThe aim of this study was to evaluate the time trend of seropositivity of Helicobacter pylori (H. pylori) over the period of 13 years in an asymptomatic Korean population, and investigate associated risk factors.MethodsThis cross-sectional nationwide multicentre study surveyed anti-H. pylori IgG antibodies in 19,272 health check-up subjects (aged [greater than and equal to]16 years) in 2011. Risk factors for H. pylori infection were investigated using logistic regression. Seropositivity in asymptomatic subjects without H. pylori eradication was compared between the years 1998 and 2005. Birth cohort effects were also evaluated.ResultsAfter exclusion of subjects with a history of H. pylori eradication therapy (n = 3,712, 19.3%) and gastric symptoms (n = 4,764, 24.7%), the seroprevalence of H. pylori infection was 54.4% in 10,796 subjects. This was significantly lower than the seroprevalence of 59.6% in 2005 and that of 66.9% in 1998, and this decrease of seropositivity of H. pylori became widespread across all ages and in most areas of the country. This decreasing trend could be explained by cohort analysis. All younger birth cohorts had a lower seroprevalence of H. pylori than older birth cohorts at the same age. Decreased seroprevalence within the same birth cohorts also accounted for this phenomenon. Clinical risk factors of H. pylori infection were higher cholesterol level ([greater than and equal to] 240 mg/dl) (OR = 1.33; 95% CI = 1.14-1.54), male gender, older age, low income, and residence in a rural area.ConclusionsA decreasing trend of H. pylori seroprevalence due to a birth cohort effect requires further studies on its related human host factors as well as socio-economic and hygienic factors. In addition, the relationship between H. pylori infection and high cholesterol level needs more investigation regarding underlying pathogenesis.

Seroprevalence of Helicobacter pylori in Korea: A multicenter, nationwide study conducted in 2015 and 2016

“…We found that the capital region (Seoul and Gyeonggi) showed lower H. pylori seropositivity than other areas. This trend was also reported in a previous Korean study in 2011 9. Interestingly, as the distance from the capital region increased, so did the odds ratio of H. pylori prevalence.…”

“…Comparison of Helicobacter pylori seropositivity with previous data 7, 8, 9 in asymptomatic adult participants in South Korea…”

“…We compared the H. pylori seropositivity of asymptomatic participants among the 1998, 2005, and 2011 studies7, 8, 9 and this study. The overall seropositivity of 51.0% (95% CI: 49.6‐52.4%) in this study represented a significant decrease from 66.9% (95% CI: 65.4‐68.6%) in 1998, 59.6% (95% CI: 58.5‐60.7%) in 2005, and 54.4% (95% CI: 53.5‐55.4%) in 2011 ( P  <   .001) (Figure 2).…”

“…Multivariable logistic regression was used for the investigation of risk factors for H. pylori seropositivity. We used the Cochran‐Armitage trend test for the comparison of H. pylori seroprevalence among the data published in 1998,7 2005,8 2011,9 and in this study. We only analyzed the results of asymptomatic participants from previous studies.…”

“…Accordingly, determination of the H. pylori prevalence of normal asymptomatic participants is crucial for the establishment of national health policies in these Eastern Asia countries. Nationwide studies of H. pylori prevalence were performed in Korea in 1998, 2005, and 2011 7, 8, 9. Although these studies obtained data from a large number of participants, they had several notable limitations, such as inconsistencies in test methods, uneven study populations, and lack of socioeconomic information.…”