Salt intake and gastric precancerous lesions in a high risk Colombian population
Description
Salt has been identified as a risk factor for gastric cancer and essential hypertension. The purpose of this study was to test the relationship between salt intake and gastric precancerous lesions and blood pressure levels. This study also provided an opportunity to link salt intake with specific phases in the pathogenesis of precancerous lesions in the stomach A cross-sectional study was conducted in the Andean population in Colombia, which has one of the highest incidence rates of gastric cancer in the world. Subjects with gastric precancerous lesions were compared with normal subjects regarding their salt intake. A total of 289 subjects were examined by gastroscope and four gastric biopsies and a sample of gastric juice were obtained from each of them Urine samples were collected for sodium, potassium and creatinine measurements. All subjects were interviewed and their blood pressures were recorded. Sodium-creatinine ratio was the end point used for correlation with detailed histologic data from the biopsies. Using the same criterion, the role of high nitrite content in gastric juice as a risk factor for gastric cancer was evaluated. Sodium-potassium ratio was used to test the association between salt intake and blood pressure Two diagnostic schemes were used in this study, the global diagnosis and the numerical pathological scores describing the severity and extent of the lesions. The results of the analyses on salt indicated that high salt intake was a risk factor of gastric precancerous lesions. Chronic atrophic gastritis was found to be the stage at which high salt appeared to act as a co-carcinogen. A significant correlation was obtained between sodium-potassium ratio (Na/K) and systolic blood pressure The results also showed that pH and nitrite level in the gastric juice were higher for subjects with gastric precursor lesions relative to lesion-free subjects. A significant relationship was also demonstrated between a rise in pH and an increase in nitrite levels. Furthermore, the results showed that high nitrite concentration in gastric juice was a risk factor in the development of histologically diagnosed precancerous lesions of the stomach, namely, intestinal metaplasia and dysplasia. (Abstract shortened with permission of author.)