Study of Clinical and Genetic Risk Factors for Aspirin-inducec Gastric Mucosal Injury

• Published in: 中华医学杂志：英文版 no. 2; pp. 174 - 180
• Main Author: Yun Wu Ying Hu Yu-Jing Chi Jian-Hua Zhou Yuan-Yuan Zhang Yu-Lan Liu
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Logistic回归分析; 临床资料; 十二指肠溃疡; 危险因素; 胃黏膜; 膜损伤; 遗传; 阿司匹林
• ISSN: 0366-6999; 2542-5641

Background： Current knowledge about clinical and genetic risk factors for aspirin-induced gastric mucosal injury is not sufficient to prevent these gastric mucosal lesions. Methods： We recruited aspirin takers as the exposed group and healthy volunteers as the control group. The exposed group was categorized into two subgroups such as subgroup A as gastric mucosal injury diagnosed by gastroscopy, including erosion, ulcer or bleeding of the esophagus, stomach, or duodenum; subgroup B as no injury of the gastric mucosa was detected by gastroscopy. Clinical information was collected, and 53 single nucleotide polymorphisms were evaluated. Results： Among 385 participants, 234 were in the aspirin-exposed group. According to gastroscopy, 82 belonged to subgroup A, 91 belonged to subgroup B, and gastroscopic results of 61 participants were not available. Using the Chi-square test and logistic regression, we found that peptic ulcer history （odds ratio [OR] = 5.924, 95% confidence intervals [C/]： 2.115-16.592）, dual anti-platelet medication （OR = 3.443, 95% CI： 1.154-10.271 ）, current Helicobacterpylori infection （OR = 2.242, 95% CI： 1.032-4.870）, male gender （OR = 2.211, 95% CI： 1.027-4.760）, GG genotype ofrs2243086 （OR = 4.516, 95% CI： I. 180-17.278）, and AA genotype ofrs 1330344 （OR = 2.178, 95% CI： 1.016-4.669） were more frequent in subgroup A than subgroup B. In aspirin users who suffered from upper gastrointestinal bleeding, the frequency of the TT genotype ofrs2238631 and TT genotype ofrs2243100 was higher than in those without upper gastrointestinal bleeding. Conclusions： Peptic ulcer history, dual anti-platelet medication, tt. pylori current infection, and male gender were possible clinical risk factors for aspirin-induced gastric mucosal injury. GG genotype of rs2243086 and AA genotype of rs 1330344 were possible genetic risk factors. TT genotype ofrs2238631 and TT genotype ofrs2243100 may be risk factors for upper gastrointestinal bleeding in aspirin users.