Risk factors for peptic ulcer disease: a population based prospective cohort study comprising 2416 Danish adults

Rosenstock, S
Jørgensen, T
Bonnevie, O
Andersen, L

¹Copenhagen County Centre for Preventive Medicine, Glostrup University Hospital, Building 8.7. Nordre Ringvej, DK 2600 Glostrup, Denmark
²Department of Medicine I, Bispebjerg Hospital, Bispebjerg Bakke 23, DK 2400, Copenhagen, Denmark
³Department of Infectious Hygiene 5222, Rigshospitalet, Blegdamsvej 3, DK 2100, Copenhagen, Denmark

Correspondence to: Dr S Rosenstock, Department of Surgery D26, Glostrup University Hospital, Nordre Ringvej 2600 Glostrup, Denmark; [email protected]

Accepted 03 September 2002

This study was supported by the Ingeborg Roikjer Foundation (9043), the Danish Health Insurance Foundation (11/099-95), the Danish Medical research Council (12-1844-1), the Else and Mogens Wedell-Wedellsborg Foundation (6686-1), and the Jakob and Olga Madsen Foundation.

Gut 52(2):p 186-193, February 2003.

Background:

No population based prospective cohort study has previously assessed the impact of multiple risk factors, including Helicobacter pylori infection, on the incidence of peptic ulcer disease (PUD).

Aims:

To identify risk factors for PUD and estimate their relative impact on ulcer incidence.

Subjects:

Random sample of 2416 Danish adults with no history of PU.

Methods:

Sample members were interviewed in 1982 and 1994. PUs diagnosed within the observation period were verified through medical records. Information on psychosocial factors, lifestyle practices, and medication was obtained from a questionnaire completed at study entry. H pylori infection status was determined by ELISA.

Results:

The main risk factors for PUD were H pylori infection (odds ratio 4.3 (95% confidence interval 2.2; 8.3)), tobacco smoking (3.8 (1.7; 9.8)), and use of minor tranquillisers (3.0 (1.4; 6.6)). Intake of non-steroid anti-inflammatory drugs did not affect the incidence of PUD (0.4 (0.1; 2.3)). In those with increased antibodies to H pylori, tobacco smoking (12.7 (2.8; 56.8)) and intake of spirits (2.4 (1.1; 5.4)) increased the risk of PUD whereas moderate leisure time physical activity (0.3 (0.2; 0.7)) protected against PUD.

Conclusions:

Tobacco smoking and H pylori infection are the main risk factors for PUD in Danish adults. Physical activity may protect against PUD in those infected with H pylori.