S1235 Predicted Probability of Gastric Intestinal Metaplasia Adjusted for Age and Current H. pylori Status in Adult Patients in the Dominican Republic

Introduction: Gastric intestinal metaplasia (GIM) is associated with a sixfold increased risk of developing future gastric adenocarcinoma. It is often linked to Helicobacter pylori infection and older age. Although the Dominican Republic (DR) has a high prevalence of H. pylori infection, data on its relationship with the development of GIM remains uncovered. This study aimed to estimate the predicted probability of GIM, adjusted for age and current H. pylori infection. Methods: A cross-sectional retrospective study involving 781 adult patients who underwent esophagogastroduodenoscopy with gastric biopsies was conducted at an outpatient facility serving a middle-to-upper-class population in the DR in 2024. Histopathological confirmation of GIM and testing for active H. pylori infection was obtained. Statistical modeling analysis with logistic regression was employed to estimate the predicted probability of GIM, adjusting for age and H. pylori status. Results: Of the 781 patients that were included, 114 (14.6%) had GIM, of whom 109 (95.6%) had the complete subtype. The mean age among patients with and without GIM was 62.4 (±10.9) and 53.9 (±13.1) years, respectively. Females comprised 43% of patients with GIM and 51.4% of those without GIM. Overall, 10.2% had current H. pylori infection. Active H. pylori infection was detected in 21.9% of GIM-positive patients and 8.3% of GIM-negative patients. A history of H. pylori infection was present in 37.2% of GIM-positive patients compared to 14.3% of those without GIM. The probability of GIM increased with age in both H. pylori-positive and negative patients. Furthermore, the presence of active H. pylori infection significantly increased the risk of GIM. Conclusion: Current and past H. pylori infections, as well as increasing age, are key risk factors for GIM. In contrast, female sex appears to provide some protection. Predictive modeling revealed a significant increase in risk after age 50, which doubled when adjusted for H. pylori, underscoring the importance of eradication, particularly in older adults. The prevalence of H. pylori and GIM was lower than expected in this underdeveloped country, with most cases being of the complete subtype. This could be attributed to the lower prevalence of H. pylori in populations with higher socioeconomic status, such as this one. These findings support further research on the national prevalence of GIM and the development of individualized, risk-based screening strategies.