Abstract: Purpose: Gastric atrophy (GA), usually linked to chronic infection with Helicobacter pylori (H. pylori), may over time evolve into gastric malignancy. Besides H. pylori, high salt intake may play a role in GA development. This study evaluates cross sectionally the association between salt intake and GA in Chilean adults.
Methods: Population-based samples were recruited from two sites, Antofagasta and Valdivia, partaking in the Epidemiological Investigation of Gastric Malignancies. At recruitment, participants answered questionnaires and provided biospecimens. Salt intake (g/day) was estimated from casual spot urine samples using the Tanaka equation. GA was determined by serum pepsinogen levels. Only participants ≥ 40 to 70 years of age were considered in this analysis, n = 565. For the association between salt intake (as sex-specific quartiles) and GA, odds ratios (ORs) and the corresponding 95% confidence intervals (CI) were estimated through multivariable logistic regression.
Results: In women, the multivariable-adjusted OR for GA comparing quartile 4 of the estimated salt intake (12.8 g/day) to quartile 1 (6.6 g/day) was 1.18 (95% CI 0.52-2.68, P-trend = 0.87). The corresponding OR in men was 0.49 (95% CI 0.19-1.27, P-trend = 0.17) with salt intakes of 12.8 g/day and 7.1 g/day for quartiles 4 and 1, respectively.
Conclusion: There was little evidence for an association between salt intake estimated from spot urine and GA risk in our cross-sectional analysis of middle aged and older adults in Chile. Reverse causation bias cannot be ruled out and the sample size was limited to provide more precise estimates.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
References: Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249. https://doi.org/10.3322/CAAC.21660. (PMID: 10.3322/CAAC.2166033538338)
Ferlay J, Colombet M, Soerjomataram I et al (2018) Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 144:ijc31937. https://doi.org/10.1002/ijc.31937. (PMID: 10.1002/ijc.31937)
Plummer M, Franceschi S, Vignat J et al (2015) Global burden of gastric cancer attributable to pylori. Int J Cancer 136:487–490. https://doi.org/10.1002/ijc.28999. (PMID: 10.1002/ijc.2899924889903)
Rugge M, Genta RM, Graham DY et al (2016) Chronicles of a cancer foretold: 35 years of gastric cancer risk assessment. Gut 65:721. https://doi.org/10.1136/GUTJNL-2015-310846. (PMID: 10.1136/GUTJNL-2015-31084626927528)
Correa P (1992) Human gastric carcinogenesis: a multistep and multifactorial process—First American Cancer Society Award lecture on cancer epidemiology and prevention. Cancer Res 52.
WCRF/AICR (2018) Diet, nutrition, physical activity and cancer: a global perspective. Continuous Update Project Expert Report 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Summary-of-Third-Expert-Report-2018.pdf . Accessed 15 Apr 2019.
Yin J, Yi J, Yang C et al (2021) Chronic atrophic gastritis and intestinal metaplasia induced by high-salt and N-methyl-N’-nitro-N-nitrosoguanidine intake in rats. Exp Ther Med 21:1–1. https://doi.org/10.3892/ETM.2021.9746. (PMID: 10.3892/ETM.2021.9746)
Gaddy JA, Radin JN, Loh JT et al (2013) High dietary salt intake exacerbates Helicobacter pylori-induced gastric carcinogenesis. Infect Immun 81:2258–2267. https://doi.org/10.1128/IAI.01271-12. (PMID: 10.1128/IAI.01271-12235691163676043)
Kato S, Tsukamoto T, Mizoshita T et al (2006) High salt diets dose-dependently promote gastric chemical carcinogenesis in Helicobacter pylori-infected Mongolian gerbils associated with a shift in mucin production from glandular to surface mucous cells. Int J Cancer 119:1558–1566. https://doi.org/10.1002/ijc.21810. (PMID: 10.1002/ijc.2181016646055)
Fox JG, Dangler CA, Taylor NS et al (1999) High-salt diet induces gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL/6 mice. Cancer Res 59:4823–4828. (PMID: 10519391)
Dias-Neto M, Pintalhão M, Ferreira M, Lunet N (2010) Salt intake and risk of gastric intestinal metaplasia: systematic review and meta-analysis. Nutr Cancer 62:133–147. https://doi.org/10.1080/01635580903305391. (PMID: 10.1080/0163558090330539120099187)
Broutet N, Mégraud F, O’Morain C et al (2002) Risk factors for atrophic chronic gastritis in a European population: results of the Eurohepygast study. Gut 50:779–785. https://doi.org/10.1136/GUT.50.6.779. (PMID: 10.1136/GUT.50.6.779)
Pintalhao M, Dias-Neto M, Peleteiro B et al (2010) Salt intake and type of intestinal metaplasia in Helicobacter pylori-infected Portuguese men. Nutr Cancer 62:1153–1160. https://doi.org/10.1080/01635581.2010.513799. (PMID: 10.1080/01635581.2010.51379921058204)
Appel LJ, Foti K (2017) Sources of dietary sodium. Circulation 135:1784–1787. https://doi.org/10.1161/CIRCULATIONAHA.117.027933. (PMID: 10.1161/CIRCULATIONAHA.117.027933284838295494975)
McLean RM (2014) Measuring population sodium intake: a review of methods. Nutrients 6:4651–4662. https://doi.org/10.3390/nu6114651. (PMID: 10.3390/nu6114651253536614245554)
Song JH, Kim YS, Heo NJ et al (2017) High salt intake is associated with atrophic gastritis with intestinal metaplasia. Cancer Epidemiol Biomarkers Prev 26:1133–1138. https://doi.org/10.1158/1055-9965.EPI-16-1024. (PMID: 10.1158/1055-9965.EPI-16-102428341758)
Strom BL, Yaktine AL, Oria M (2013) Sodium intake in populations. National Academies Press, Washington, D.C.
Ministry of Health (Chile) Chapter V.2.7. Salt consumption (Capitulo V.2.7 Consumo de sal) In: National Health Survey 2009–2010 (Encuesta Nacional de Salud 2009–2010). Santiago de Chile. https://www.minsal.cl/portal/url/item/bcb03d7bc28b64dfe040010165012d23.pdf . Accessed 22 Oct 2019.
Campino C, Hill C, Baudrand R et al (2016) Usefulness and pitfalls in sodium intake estimation: comparison of dietary assessment and urinary excretion in chilean children and adults. Am J Hypertens 29:1212–1217. https://doi.org/10.1093/ajh/hpw056. (PMID: 10.1093/ajh/hpw05627279009)
WHO (2012) Guideline: sodium intake for adults and children. World Health Organization (WHO) Geneva. https://www.who.int/publications/i/item/9789241504836 . Accessed 29 July 2020.
Tanaka T, Okamura T, Miura K et al (2002) A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens 16:97–103. https://doi.org/10.1038/sj/jhh/1001307. (PMID: 10.1038/sj/jhh/100130711850766)
Mill JG, Rodrigues SL, Baldo MP et al (2015) Estudo de validação das equações de Tanaka e de Kawasaki para estimar a excreção diária de sódio através da coleta da urina casual. Rev Bras Epidemiol 18:224–237. https://doi.org/10.1590/1980-5497201500060020. (PMID: 10.1590/1980-549720150006002027008617)
Herrero R, Heise K, Acevedo J et al (2020) Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: the ENIGMA study in Chile. PLoS ONE. https://doi.org/10.1371/JOURNAL.PONE.0237515. (PMID: 10.1371/JOURNAL.PONE.0237515329158737485889)
Bray F, Colombet M et al (2017) Cancer Incidence in Five Continents, Vol. XI (electronic version). International Agency for Research on Cancer, Lyon. https//ci5.iarc.fr.
Hendriksen MA, Van Raaij JM, Geleijnse JM et al (2014) Monitoring salt and iodine intakes in Dutch adults between 2006 and 2010 using 24 h urinary sodium and iodine excretions. Public Health Nutr 17:1431–1438. https://doi.org/10.1017/S1368980013001481. (PMID: 10.1017/S136898001300148123739290)
Gibson RS (2005) Principles of nutritional assessment, 2nd edn. Oxford University Press, New York.
Miki K (2006) Gastric cancer screening using the serum pepsinogen test method. Gastric Cancer 9:245–253. https://doi.org/10.1007/S10120-006-0397-0/METRICS. (PMID: 10.1007/S10120-006-0397-0/METRICS17235625)
Leja M, Camargo MC, Polaka I et al (2017) Detection of gastric atrophy by circulating pepsinogens: a comparison of three assays. Helicobacter. https://doi.org/10.1111/hel.12393. (PMID: 10.1111/hel.12393288911365847288)
Muñoz N, Plummer M, Vivas J et al (2001) A case-control study of gastric cancer in Venezuela. Int J cancer 93:417–423. https://doi.org/10.1002/IJC.1333. (PMID: 10.1002/IJC.133311433408)
Valero-Morales I, Tan M, Pei Y et al (2022) 24-hour sodium and potassium excretion in the Americas: a systematic review and meta-analysis. Rev Panam Salud Publ. https://doi.org/10.26633/RPSP.2022.199. (PMID: 10.26633/RPSP.2022.199)
Shimonovich M, Pearce A, Thomson H et al (2021) Assessing causality in epidemiology: revisiting Bradford Hill to incorporate developments in causal thinking. Eur J Epidemiol 36:873–887. https://doi.org/10.1007/S10654-020-00703-7/TABLES/5. (PMID: 10.1007/S10654-020-00703-7/TABLES/533324996)
Xu Y, Yan Y, Hou MX, Liu YE (2015) NaCl pretreatment attenuates H. pylori-induced DNA damage and exacerbates proliferation of gastric epithelial cells (GES-1). Infect Agent Cancer 10:8. https://doi.org/10.1186/s13027-015-0003-3. (PMID: 10.1186/s13027-015-0003-3258592774391598)
Malfertheiner P, Megraud F, O’Morain CA et al (2017) Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 66:6–30. https://doi.org/10.1136/gutjnl-2016-312288. (PMID: 10.1136/gutjnl-2016-31228827707777)
_0.png)
Processing Request
No Comments.