Short term micronutrient-antioxidant supplementation has no impact on a serological marker of gastric atrophy in Zambian adults: retrospective analysis of a randomised controlled trial

Abstract

BackgroundGastric cancer is a major contributor to cancer deaths in Zambia but, as elsewhere, no preventive strategies have been identified. We set out to investigate the possibility of reducing gastric atrophy, a premalignant lesion, using micronutrient-antioxidant supplementation.MethodsWe analysed 215 archival samples from a randomised controlled trial of micronutrient-antioxidant supplementation carried out from 2003 to 2006. Participants were randomised to receive either the supplement or placebo and had been taking the allocated intervention for a mean of 18 (range 14–27) months when the samples used in this study were taken. We used low pepsinogen 1 to 2 (PEP1:2) ratio as a surrogate marker of gastric atrophy. A PEP 1:2 ratio of less than three was considered low. HIV serology, age, nutritional status, smoking, alcohol intake and gastric pH were also analysed. Ethical approval was obtained from the University of Zambia Biomedical Research Ethics Committee (011-04-12). The randomized trial was registered (ISRCTN31173864).ResultsThe overall prevalence of low PEP 1:2 ratio was 15/215 (7%) and it did not differ between the placebo (8/103, 7.8%) and micronutrient groups (7/112, 6.3%; HR 1.24; 95% CI 0.47-3.3; P = 0.79). The presence of low PEP 1:2 ratio was not influenced by HIV infection (HR 1.07; 95% CI 0.37-3.2; P =0.89) or nutritional status but it inversely correlated with gastric pH (Spearman’s rho = -0.34; P = 0.0001). Age above 40 years was associated with atrophy, but neither alcohol nor smoking had any influence.ConclusionShort term micronutrient supplementation does not have any impact on PEP 1:2 ratio, a serological marker of gastric atrophy. PEP 1:2 ratio inversely correlates with gastric pH.

HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study

“…Excluded were those with evidence of ART failure, use of gastric acid suppressing medication, presence of active gastrointestinal disease or significant co-morbidities such as chronic liver or kidney disease. For comparison, all proven HIV negative community volunteers from a previous study were included [14]. The university of Zambia biomedical research ethics committee (Ref no.…”

Gastric cancer detection by non‐blood‐based liquid biopsies: A systematic review looking into the last decade of research

“…In the last decade, 45% of published studies that explored the role of non‐blood‐based circulating biomarkers in GC detection characterized GJ samples following a case‐control study design and mostly including Han Chinese participants (23 of 36 reports) 67–89 . A high level of heterogeneity regarding the class of analyzed biomarkers was observed: (a) 17 studies focused on distinct nucleic acids, including mRNA, miRNA, long non‐coding RNA (lncRNA), long intergenic non‐coding RNA (lincRNA), piwi‐interacting RNA (piRNA), circular RNA, and DNA 67,68,71,74–79,81–86,88,90 ; (b) nine studies on proteins or amino acids 69,70,72,80,91–94 ; (c) four studies primarily on metabolites 95–98 ; (d) two studies focused on glycoproteins, including CEA, CA19‐9, CA72‐4, and CA50 99,100 ; (e) two studies on microbiota 89,101 ; (f) one study on intrinsic fluorescence spectra 87 ; (g) one study on blood 102 . GC‐associated biomarkers found in GJ with reported expression, AUC, or sensitivity and specificity values, are summarized in Table 4.…”

“…a Only microbiota genera and species with reported relative abundance and reaching AUC >0.70 were included (suggested by 38 as moderate accuracy). b P < 0.001. c Klebsiella, Subdoligranulum, Prevotella 9, Streptococcus, Ruminiclostridium 9.LOPES ET AL.T A B L E 3 CA5099,100 ; (e) two studies on microbiota89,101 ; (f) one study on intrinsic fluorescence spectra87 ; (g) one study on blood 102. GCassociated biomarkers found in GJ with reported expression, AUC, or sensitivity and specificity values, are summarized in Table4.…”