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The Association between Salt and Potential Mediators of the Gastric Precancerous Process

Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Author to whom correspondence should be addressed.
Cancers 2019, 11(4), 535;
Received: 18 January 2019 / Revised: 28 March 2019 / Accepted: 4 April 2019 / Published: 15 April 2019
(This article belongs to the Special Issue Helicobacter pylori Associated Cancer)
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Background: The process by which salt affects the gastric precancerous process has not been adequately studied in humans. Methods: We investigated the effects of salt on gastric inflammation, epithelial damage, the density of Helicobacter pylori infection, and gastric epithelial cell proliferation, all of which may be mediators between salt and gastric precancerous/cancerous lesions. These potential mediators were measured using gastric biopsies as: (a) the density of polymorphonuclear and mononuclear cells (gastric inflammation), (b) mucus depletion (gastric epithelial damage), and (c) the severity of H. pylori infection. Salt intake was measured with spot urine samples (using urinary sodium/creatinine ratios), self-reported frequency of adding salt to food, and as total added salt. Results: The average sodium/creatinine ratio (at baseline and post-treatment at five months) was associated with increased epithelial damage over the 12-year follow-up period among those with a greater severity of chronic inflammation and among those with continued H. pylori infection after treatment at five months. This association was stronger when both severe gastric inflammation and H. pylori infection were present at five months (ß: 1.112, 95% CI: 0.377, 1.848). Conclusion: In humans, salt was associated with an increase in epithelial damage in stomachs with more severe previous H. pylori-induced chronic inflammation. View Full-Text
Keywords: salt; gastric inflammation; epithelial damage; Helicobacter pylori salt; gastric inflammation; epithelial damage; Helicobacter pylori
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Thapa, S.; Fischbach, L.A.; Delongchamp, R.; Faramawi, M.F.; Orloff, M. The Association between Salt and Potential Mediators of the Gastric Precancerous Process. Cancers 2019, 11, 535.

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