Submitted, Not Presented: Stomach.

Abstract

Introduction: Osteoporosis is often regarded as the disease specific to female, whereas male patients with osteoporosis are increasing as well. Although the main factor of osteoporosis in female is the decrease of estrogen production, the etiology is not clear for men. In Western countries, infection of H. pylori, particularly CagA-positive strain, has been shown as a possible risk for osteoporosis in male. The absorption of calcium is affected by acidity of gastrointestinal tract. In Japan, most H. pylori strains are CagA-positive and severe gastric mucosal atrophy is often observed in infected patients causing the reduction of gastric acid secretion. Thus, there could be more clear relationship between H. pylori infection and loss of bone density in Japan comparing with Western populations. The aim of this study was to examine whether H. pylori infection associates with loss of bone density in Japanese healthy males. Methods: 295 healthy male adults who attended the mass survey in 2014 were enrolled into the study (mean age: 50.2 ± 15.4 years old). We measured H. pylori stool antigen and the titer of serum antibodies to H. pylori. H. pylori status was defined as positive or negative when both tests showed concordant results. The bone density was examined calcaneal osteo sono-assessment index (OSI) using quantitative ultrasound. Osteopenia was defined when measured OSI was less than 1.0 SD from the mean OSI of the young age (20-44 years old) according to WHO diagnostic criteria. We performed logistic regression models and calculated the adjusted odds ratio (OR) for having osteopenia as a dependent variable. The independent variables were age, BMI, serum level of estradiol, the intake of calcium per day, smoking, drinking, periodical exercise, last educational background and H. pylori infection. Results: Bivariate and multivariate analyses revealed that only age was significantly different between subjects with or without osteopenia. In multivariate analysis, the adjusted OR of age for osteopenia was 2.88 (95%CI: 1.46-5.68, p < 0.001). On the other hand, the adjusted OR of H. pylori infection for osteopenia was 0.92 (0.47-1.81; p=0.81). Conclusion: Age was a significant risk for developing osteopenia in Japanese males. Unlike Western populations, no significant association was found between H. pylori infection and osteopenia in this series of adult males.