Epidemiology of gastroduodenal erosions in the general population: Endoscopic results of the systematic investigation of gastrointestinal diseases in China (SILC)

Abstract

Objective. Population-based endoscopic studies of gastroduodenal erosions are limited in the world. This study describes features of gastroduodenal erosions in a representative sample of the population in Shanghai, China. Material and methods. A total of 3600 individuals (aged 18–80 years) were randomly selected from the Shanghai region and asked to undergo endoscopy and provide a blood sample to test for H. pylori infection. Participants completed a general information questionnaire, and a Chinese version of the Reflux Disease Questionnaire; 20% were also invited to complete the 36-item Short Form Health Survey and Epworth Sleepiness Scale. Associations between gastroduodenal erosions and other factors were analyzed using a multiple logistic regression model. Results. In total, 3153 individuals (87.6%) completed the survey and provided blood samples, 1030 (32.7%) agreed for endoscopy and 1022 participants were suitable for analysis. In all, 510 participants (49.9%) had gastroduodenal erosions (502 with gastric erosions; 26 with duodenal erosions). No significant association was found between H. pylori infection and gastroduodenal erosions. Increasing age, increasing BMI and current smoking were independent predictors for the presence of gastric erosions, but not of duodenal erosions. Duodenal erosions were more prevalent among men, which were not found in gastric erosions. The majority of individuals with gastroduodenal erosions were asymptomatic. Conclusions. Gastroduodenal erosions are more common in China than in Europe, North America, and South America. No significant association was found between H. pylori infection and gastroduodenal erosions in China. The majority of individuals with gastroduodenal erosions were asymptomatic.