Relationship between serologically diagnosed chronic atrophic gastritis, Helicobacter pylori, and environmental factors in Japanese men.

Background: Whereas chronic atrophic gastritis is known to be an intermediate stage in gastric carcinogenesis, information is sparse about factors associated with this precancerous lesion except for Helicobacter pylori. Methods: In a cross-sectional study of 566 men aged 50-55 years in the Japan Self-Defense Forces, we examined the relation of H. pylori infection, smoking, alcohol use, and dietary factors to the prevalence of chronic atrophic gastritis as determined by serum pepsinogen I and pepsinogen II (I/II ratio < 3.0, and pepsinogen I < 70 ng/ml). Chronic atrophic gastritis was classified as severe when the pepsinogen I/II ratio was <2.0, and as moderate otherwise. Results: The overall prevalence of chronic atrophic gastritis was 35.7% (202 of 566). The seropositivity of H. pylori was associated with a 10-fold increase in the risk of chronic atrophic gastritis, and the association was much stronger for moderate atrophic gastritis. Neither cigarette smoking nor alcohol consumption was relate...