| Objective To investigate the interaction between Helicobacter pylori and high-salt diet in the occurrence of gastric cancer,and to provide scientific basis for the formulation of gastric cancer prevention and control policies and the monitoring of gastric cancer risk factors by case-control study in 14 counties(districts)of four provinces in Huaihe Region.Methods Using 1:2 matched case-control study,through various counties CDC staff to questionnaire survey of physical examination Helicobacter pylori inspection and salty preference measure.Helicobacter pylori inspection by 13C urea breath test were used,high salt diet indicators in and salty preference measure>2 and salty taste.The risk factors for gastric cancer were analyzed by conditional Logistic regression model.The interaction between H.pylori infection and high-salt diet was investigated by crossover analysis and significance test was conducted when other factors were not considered.When other factors were considered,the multiplicative interaction was calculated by 1:2 matched conditional Logistic regression model.The additive interaction model was calculated by the Excel table compiled by Andresson et al,and the percentage of Attributable proportion of interaction(AP),synergy index(S),Relative excess risk of interaction(RERI)and 95%confidence interval were obtained for validation.Results Equilibrium test results showed that there was a difference between the case group and the control group in education level and family income.Univariate analysis showed that H.pylori infection,high salt diet(salty preference measure result>2),heavy smoking,history of gastric ulcer,family history of first-degree relatives and other 24 factors are risk factors and 6 factors such as regular exercise are protective factors for the gastric cancer.The results of multifactorial analysis showed that salty taste(OR=1.77),dry and hard diet(OR=1.97),spicy foods(OR=1.38),eating fast(OR=1.27),irregular diet(OR=1.43),high meat intake(OR=1.40),exposure to secondhand smoke(OR=1.57),frequent temper tantrums(OR=2.23),frequent sulking(OR=1.84),history of gastric ulcer(OR=3.84),history of atrophic gastritis(OR=3.61),history of gastroesophageal reflux(OR=2.69),family history of tumor(OR=1.34),high salt diet(salty preference measure result>2)(OR=1.34),and HP infection(OR=1.44)were risk factors for gastric cancer;Higher education(secondary school and above)(OR=0.593),middle to higher income(per capita monthly household income>500 yuan)(ORmiddle income=0.571)(ORhigher income=0.469),high intake of garlic(OR=0.646),and regular exercise(OR=0.647)were protective factors for gastric cancer.Interaction results showed that there was no multiplicative interaction between H.pylori infection and high salt diet or salty taste(PHP*high salt diet:0.371,PHP*food taste preference:0.909),nor additive interaction(APHP*high salt diet:0.237,95%CI:-0.072-0.546,SHP*high salt diet:2.068,95%CI:0.460-9.290,RERI HP*high salt diet:0.438,95%CI:0.133-1.008;APHP*food taste preference:0.151,95%CI:-0.135-0.437,SHP*food taste preference:1.330,95%CI:0.730-2.422,RERIHP*food taste preference:0.386,95%CI:-0.400-1.173).Conclusion Dry and hard diet,spicy foods,eating fast,irregular diet,high meat intake,exposure to secondhand smoke,frequent temper tantrums,frequent sulking,history of gastric ulcer,history of atrophic gastritis,history of gastroesophageal reflux,family history of tumor,high salt diet(salty preference measure result>2),and HP infection were the huaihe river area residents 14 counties of gastric cancer risk factors,Higher education(secondary school and above),middle to higher income(per capita monthly household income>500 yuan),high intake of garlic and regular exercise are protective factors for gastric cancer.No interaction between HP infection and high salt diet was observed in the occurrence of gastric cancer. |
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