A study of factors related to aspirin-induced early phase gastric mucosal injury in elderly people / 中华老年医学杂志

ABSTRACT

Objective:To study clinical and genetic factors for early phase gastric mucosal injury due to long-term aspirin use in elderly people treated with angiotensin-converting enzyme inhibitors(AVCEI)/angiotensin II AT-1 receptor blockers(ARB)or statins.Methods:Four hundred and sixty-seven elderly persons taking 100 mg aspirin per day for a long time combined with ACEI/ARB or statins in our hospital were enrolled and retrospectively analyzed.According to endoscopy results, patients were divided into the normal gastric mucosa group(n=125), chronic gastritis group(n=199)and gastric mucosal erosion group(n=143). Clinical features and SLCO1B1 genetic polymorphisms affecting the absorption of ACEI/ARB and statins were statistically analyzed.Results:Compared with the normal gastric mucosa group, reduced glomerular filtration rate(GFR)was a risk factor for chronic gastritis and gastric mucosal erosion[(66.5±24.4) ml·min·1.73 m -2vs.(70.9±18.5) ml·min·1.73 m -2, OR=5.06, 95% CI 2.14-11.51, P<0.01]. Advanced age[(78.5±10.1) years old vs.(71.5±9.6) years old, OR=1.33, 95% CI 1.04-2.87, P<0.05], history of peptic ulcer[14.0% or 20/143 vs.5.6% or 7/125, OR=2.41, 95% CI 1.08-5.01, P<0.05], no prescription of proton pump inhibitor[18.2% or 26/143 vs.50.4% or 63/125, OR=0.18, 95% CI 0.11-0.31, P<0.01], lower GFR[(55.8±23.1) ml·min·1.73 m -2vs.(70.9±18.5) ml·min·1.73 m -2, OR=8.04, 95% CI 3.02-22.6, P<0.01]and SLCO1B1*1b diplotype[42.0% or 60/143 vs.24.0% or 30/125, OR=2.64, 95% CI 1.59-4.17, P<0.05]were risk factors for gastric mucosal erosion. Conclusions:The SLCO1B1*1b diplotype may increase the risk of gastric mucosal erosion induced by aspirin via weakening the protective effects of ACEI/ARB and statins on the gastric mucosa.Advanced age, a history of peptic ulcer, no prescription of proton pump inhibitors and renal function decline are risk factors for gastric mucosal injury.