- Email: [email protected]
Time Trend in the Prevalence of Helicobacter Pylori Infection in Korea Over 18 Years and the Association with Metabolic Syndrome
*Education level was classified as low (middle school graduates or less), middle (high school graduates or university dropouts), or high (university graduates or graduates of a postgraduate course). **Household income was classified as low (less than US $ 3,000), medium (US $ 3,000 to 10,000), or high (more than US $ 10,000).
Tu1712
Tu1713
TIME TREND IN THE PREVALENCE OF HELICOBACTER PYLORI INFECTION IN KOREA OVER 18 YEARS AND THE ASSOCIATION WITH METABOLIC SYNDROME Seon Hee Lim, Nayoung Kim, Joo Sung Kim, Jeong Yoon Yim, Changhyun Lee
OUTCOME OF FECAL MICROBIOTA TRANSPLANTATION FOR RECURRENT CLOSTRIDIUM DIFFICILE INFECTION ON QUALITY OF LIFE Christine Lee, Peter T. Kim, Emma Smith Background: Fecal microbiota transplantation (FMT) has established itself as a promising treatment for recurrent Clostridium difficile infection (CDI). Despite the clinical efficacy, there is limited information regarding the impact of FMT on health-related quality of life. Using the RAND 36-Item Short Form Health Survey (RAND-36), patients who received FMT for CDI were monitored longitudinally for the following eight health scales: Physical Functioning; Role Limitations (Physical); Role Limitations (Emotional); Energy or Fatigue; Emotional Well-being; Social Functioning; Pain; and, General Health. Methods: A randomized double-blind clinical trial was completed at Canadian academic medical centers from July 2012 to September 2014 with the primary objective of comparing the efficacy of fresh versus frozen fecal microbiota transplantation. The RAND-36 instrument was administered to patients within the modified intention-to-treat population (n = 219), all of whom had recurrent and/or refractory CDI. The surveys were collected at four time points starting at baseline (pre-FMT), at Day 10, Week 5 and Week 10-12 post-FMT. Owing to the longitudinal nature of the data, we were severely challenged with missing observations, some with greater than 50% for the latter surveys. We therefore used multivariate imputation by chained equations with predictive mean matching to generate complete data sets. Following a strict protocol for various imputation diagnostics, we computed the eight health scales for each data set according to the RAND guidelines. Results: Significant improvement of health status from baseline was observed over time in all eight health parameters. In seven of the eight health scales, significant improvement was achieved as early as Day 10 post-treatment. The effect of FMT on Pain improvement appeared later at up to Week 5 (Figure 1). We believe this is likely attributable to the opportunistic nature of recurrent CDI which predominantly affects the elderly populations and those with co-morbidities, and may require a longer transition time for improvement of pain. These results were consistent for all scenarios included within the sensitivity analysis and with the current evidence that a large majority of patients experience resolution of Clostridium difficile-related diarrhea within days following successful FMT. Conclusion: Fecal microbiota transplantation can positively influence the multidimensional health profile of patients with recurrent and/or refractory CDI within 10 days following successful FMT. Table 1: Summary table of mean dimension scores, from 0 to 100, and their standard errors over time.
Backgrounds and Aims: The aim of this study was to evaluate the time trend of seropositivity of Helicobacter pylori (H. pylori) over the period of 18 years in an asymptomatic Korean population, and investigate the association with metabolic profile including presence of metabolic syndrome. Methods: This cross-sectional study surveyed anti-HP IgG antibodies with anthropometric and metabolic data in 17,152 health check-up subjects (aged 17-97) in 2016. Seropositivity in asymptomatic subjects without H. pylori eradication was compared between the years 1998, 2005, 2011, and 2016. Results: After exclusion of subjects with a history of HP eradication therapy and gastric symptoms, the seroprevalence of HP was 44.9% in 14,830 subjects. This was significantly lower than the seroprevalence of 54.4% in 2011, 59.6% in 2005 and that of 66.9% in 1998, and this decrease of seropositivity of H. pylori became widespread across all ages and in both sexes. Clinical risk factors of HP infection were lower HDL-cholesterol level [ <40 mg/dl in men, <50mg/dl in women] (OR = 1.40; 95% CI = 1.19-1.63), male gender (OR 1.36 95% CI 1.14-1.62), presence of metabolic syndrome (OR1.22, 95% CI 1.02-1.46), older age (OR 1.03, 95% CI 1.02-1.04), and low education on multivariate logistic analysis. Conclusion: A downward trend of H. pylori seroprevalence has been observed continuously, over 18 years in Korea. In addition, the relationship between H. pylori infection and low HDL-cholesterol and presence of metabolic syndrome needs more investigation regarding underlying pathogenesis. Table 1. Time trend of the seropositivity of H. pylori Ig G in Korea
yr, years old Table 2. Risk factors of Seropositivity of H. pylori Ig G
Figure 1. Pooled mean dimension scores and their associated standard error over time. Followup times marked with a star differ significantly from baseline at the 1% level of significance.
Tu1714 PROCEDURAL-RELATED AND PATIENT-RELATED FACTORS INFLUENCE CLOSTRIDIUM DIFFICILE RECURRENCE AFTER FECAL MICROBIOTA TRANSPLANT Aaron H. Mendelson, Samara Rifkin, Jessica Shay, Mohammed A. Razvi, Linda A. Lee Background: Fecal microbiota transplant (FMT) is effective therapy for Clostridum difficile infections (CDI) that have failed antibiotic therapy. Less is known about factors that influence the success or failure of FMT. Objective: To identify factors associated with success or failure of FMT therapy for CDI. Methods: Retrospective study of patients with antibioticrefractory CDI treated with FMT at a single center from 1/2013-8/2016. Early FMT failure was defined as recurrent or ongoing diarrhea along with a positive nucleic acid PCR for C. difficile toxin B gene ≤90 days after FMT. Late CDI recurrence was defined as persistence
S-949
AGA Abstracts
AGA Abstracts
and 2013. Improvement of survival was observed for localized cancer (49.5% in 2006 ~ 2008 and 58.8% in 2009 ~ 2013) and regional stages (25.3% and 29.2%, respectively). Conclusion: Over the past 15 years, the incidence of esophageal cancer has decreased in Korea and the survival has increased by early detection with advancement of therapeutic outcome.
Tu1712
Tu1713
TIME TREND IN THE PREVALENCE OF HELICOBACTER PYLORI INFECTION IN KOREA OVER 18 YEARS AND THE ASSOCIATION WITH METABOLIC SYNDROME Seon Hee Lim, Nayoung Kim, Joo Sung Kim, Jeong Yoon Yim, Changhyun Lee
OUTCOME OF FECAL MICROBIOTA TRANSPLANTATION FOR RECURRENT CLOSTRIDIUM DIFFICILE INFECTION ON QUALITY OF LIFE Christine Lee, Peter T. Kim, Emma Smith Background: Fecal microbiota transplantation (FMT) has established itself as a promising treatment for recurrent Clostridium difficile infection (CDI). Despite the clinical efficacy, there is limited information regarding the impact of FMT on health-related quality of life. Using the RAND 36-Item Short Form Health Survey (RAND-36), patients who received FMT for CDI were monitored longitudinally for the following eight health scales: Physical Functioning; Role Limitations (Physical); Role Limitations (Emotional); Energy or Fatigue; Emotional Well-being; Social Functioning; Pain; and, General Health. Methods: A randomized double-blind clinical trial was completed at Canadian academic medical centers from July 2012 to September 2014 with the primary objective of comparing the efficacy of fresh versus frozen fecal microbiota transplantation. The RAND-36 instrument was administered to patients within the modified intention-to-treat population (n = 219), all of whom had recurrent and/or refractory CDI. The surveys were collected at four time points starting at baseline (pre-FMT), at Day 10, Week 5 and Week 10-12 post-FMT. Owing to the longitudinal nature of the data, we were severely challenged with missing observations, some with greater than 50% for the latter surveys. We therefore used multivariate imputation by chained equations with predictive mean matching to generate complete data sets. Following a strict protocol for various imputation diagnostics, we computed the eight health scales for each data set according to the RAND guidelines. Results: Significant improvement of health status from baseline was observed over time in all eight health parameters. In seven of the eight health scales, significant improvement was achieved as early as Day 10 post-treatment. The effect of FMT on Pain improvement appeared later at up to Week 5 (Figure 1). We believe this is likely attributable to the opportunistic nature of recurrent CDI which predominantly affects the elderly populations and those with co-morbidities, and may require a longer transition time for improvement of pain. These results were consistent for all scenarios included within the sensitivity analysis and with the current evidence that a large majority of patients experience resolution of Clostridium difficile-related diarrhea within days following successful FMT. Conclusion: Fecal microbiota transplantation can positively influence the multidimensional health profile of patients with recurrent and/or refractory CDI within 10 days following successful FMT. Table 1: Summary table of mean dimension scores, from 0 to 100, and their standard errors over time.
Backgrounds and Aims: The aim of this study was to evaluate the time trend of seropositivity of Helicobacter pylori (H. pylori) over the period of 18 years in an asymptomatic Korean population, and investigate the association with metabolic profile including presence of metabolic syndrome. Methods: This cross-sectional study surveyed anti-HP IgG antibodies with anthropometric and metabolic data in 17,152 health check-up subjects (aged 17-97) in 2016. Seropositivity in asymptomatic subjects without H. pylori eradication was compared between the years 1998, 2005, 2011, and 2016. Results: After exclusion of subjects with a history of HP eradication therapy and gastric symptoms, the seroprevalence of HP was 44.9% in 14,830 subjects. This was significantly lower than the seroprevalence of 54.4% in 2011, 59.6% in 2005 and that of 66.9% in 1998, and this decrease of seropositivity of H. pylori became widespread across all ages and in both sexes. Clinical risk factors of HP infection were lower HDL-cholesterol level [ <40 mg/dl in men, <50mg/dl in women] (OR = 1.40; 95% CI = 1.19-1.63), male gender (OR 1.36 95% CI 1.14-1.62), presence of metabolic syndrome (OR1.22, 95% CI 1.02-1.46), older age (OR 1.03, 95% CI 1.02-1.04), and low education on multivariate logistic analysis. Conclusion: A downward trend of H. pylori seroprevalence has been observed continuously, over 18 years in Korea. In addition, the relationship between H. pylori infection and low HDL-cholesterol and presence of metabolic syndrome needs more investigation regarding underlying pathogenesis. Table 1. Time trend of the seropositivity of H. pylori Ig G in Korea
yr, years old Table 2. Risk factors of Seropositivity of H. pylori Ig G
Figure 1. Pooled mean dimension scores and their associated standard error over time. Followup times marked with a star differ significantly from baseline at the 1% level of significance.
Tu1714 PROCEDURAL-RELATED AND PATIENT-RELATED FACTORS INFLUENCE CLOSTRIDIUM DIFFICILE RECURRENCE AFTER FECAL MICROBIOTA TRANSPLANT Aaron H. Mendelson, Samara Rifkin, Jessica Shay, Mohammed A. Razvi, Linda A. Lee Background: Fecal microbiota transplant (FMT) is effective therapy for Clostridum difficile infections (CDI) that have failed antibiotic therapy. Less is known about factors that influence the success or failure of FMT. Objective: To identify factors associated with success or failure of FMT therapy for CDI. Methods: Retrospective study of patients with antibioticrefractory CDI treated with FMT at a single center from 1/2013-8/2016. Early FMT failure was defined as recurrent or ongoing diarrhea along with a positive nucleic acid PCR for C. difficile toxin B gene ≤90 days after FMT. Late CDI recurrence was defined as persistence
S-949
AGA Abstracts
AGA Abstracts
and 2013. Improvement of survival was observed for localized cancer (49.5% in 2006 ~ 2008 and 58.8% in 2009 ~ 2013) and regional stages (25.3% and 29.2%, respectively). Conclusion: Over the past 15 years, the incidence of esophageal cancer has decreased in Korea and the survival has increased by early detection with advancement of therapeutic outcome.