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Background: Peptic ulcer epidemiology has changed considerably within the past century. The aim of this study was to assess the 11-year cumulative incidence of peptic ulcer disease and examine the relationship between ulcer incidence and psychosocial and genetic factors., Methods: A random sample of 2416 Danish adults with no history of peptic ulcer disease residing in Copenhagen County, Denmark, attended a population-based prospective cohort study in 1983 and 1994. All participants reported whether they had had an ulcer diagnosed within the observation period. Information on socio-economic factors, family history of peptic ulcer disease (PUD) and lifestyle practices was obtained from a questionnaire. Lewis blood group antigens were assessed from blood samples and Helicobacter pylori infection status was determined with an in-house IgG ELISA., Results: The overall 11-year cumulative incidence proportion of PUD was 2.9% (95% CI (2.2; 3.6)), i.e. 1.6% (95% CI (1.1; 2.1)) for duodenal ulcer, and 1.3% (95% CI (0.8; 1.7)) for gastric ulcer. Poor socio-economic status increased the risk of PUD independently of H. pylori infection (odds ratio 2.7, 95% CI (1.1; 6.1)) and accounted for 17% of all ulcer cases. High physical activity at work increased the risk of PUD in people infected with H. pylori (odds ratio 2.6, 95% CI (0.8; 8.0)). Family history of PUD or Lewis blood group antigens did not relate to ulcer incidence., Conclusions: Poor socio-economic status is an important risk factor for PUD that exerts its effect independently of H. pylori infection. Strenuous work may increase the risk of PUD in people with H. pylori infection. Genetic factors do not influence the risk of PUD in Danish adults.

We evaluated the influence of Helicobacter pylori (H. pylori) infection assessed by the levels of H. pylori serum IgG-antibodies, on iron status (serum ferritin and haemoglobin) in 2794 Danes (1425 men), aged 30-60 years. The seroprevalence of H. pylori antibodies increased with age (p < 0.01). Median serum ferritin levels were significantly lower in seropositive than in seronegative men and postmenopausal women (men 114 micrograms/L vs. 120 micrograms/L, p = 0.01; premenopausal women 37 micrograms/L vs. 40 micrograms/L, p = 0.13; postmenopausal women 63 micrograms/L vs. 77 micrograms/L, p = 0.02). Seropositive subjects had a higher prevalence of iron deficiency (serum ferritin < 15 micrograms/L) than seronegative subjects. H. pylori infection has a negative influence on iron status. We hypothesize that this may be caused by increased blood losses from the gastric mucosa.

The aim of this study was to examine the relationship between housing conditions, educational level, occupational factors, and serologically diagnosed acute and chronic Helicobacter pylori infection. IgG, IgM, and IgA antibodies against Helicobacter pylori were measured by ELISA techniques in sera obtained from a random sample of 3589 Danes participating in a population study. Poor social status (odds ratio 2.2 [1.7-3.0]), short duration of schooling (odds ratio 2.0 [1.3-2.5]), lack of vocational training/education (odds ratio 1.4 [1.2-1.7]), unskilled work (odds ratio 1.7 [1.2-2.5]), and high work-related energy expenditure (odds ratio 1.4 [1.1-1.9]) increased the likelihood of chronic Helicobacter pylori infection. Chronic Helicobacter pylori infection was frequently found in people with a history of living abroad. Increased levels solely of IgM antibodies to H. pylori, interpreted as a sign of acute infection, were found more often in people who were divorced (odds ratio 2.3 [1.2-4.4]) or unmarried (odds ratio 2.0 [1.1-3.8]) and in people who worked long hours (odds ratio 2.0 [1.1-4.0]). In conclusion, educational and occupational factors relate to the likelihood of chronic Helicobacter pylori infection in adults. The rate of acute Helicobacter pylori infection is probably increased in single adults.

Objectives: This study examined the relationship between housing conditions, educational level, occupational factors, and serologically diagnosed acute and chronic Helicobacter pylori infection., Methods: Immunoglobulin G and immunoglobulin M serum antibodies against H. pylori were measured in 3589 Danish adults who participated in a population study., Results: Low socioeconomic status (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.7, 3.0), short duration of schooling (OR = 2.0, 95% CI = 1.3, 2.5), lack of training/education (OR = 1.4, 95% CI = 1.2, 1.7]), unskilled work (OR = 1.7, 95% CI = 1.2, 2.5), and high work-related energy expenditure (OR = 1.4, 95% CI = 1.1, 1.9) increased the likelihood of chronic H. pylori infection. Infection was frequent in people who had lived abroad. Increased levels solely of immunoglobulin M antibodies were found more often in people who were divorced (OR = 2.3, 95% CI = 1.2, 4.4) or unmarried (OR = 2.0, 95% CI = 1.1, 3.8) or who worked long hours (OR = 2.0, 95% CI = 1.1, 4.0)., Conclusions: Educational and occupational factors relate to the likelihood of chronic H. pylori infection in adults. The rate of acute infection is high in single individuals.

The seroprevalences of increased levels of immunoglobulin G (lgG), M (lgM), and A (lgA) antibodies to Helicobacter pylori were assessed by enzyme-linked immunosorbent assay techniques in 3,589 Danes who participated in a population study in Copenhagen County in 1982. A total of 33.9% of the study population had one or more classes of increased antibodies to H. pylori. Increased levels of lgG, lgM, and lgA antibodies to H. pylori were seen in 25.9% (95% confidence interval (Cl) 24.5-27.3), 4.5% (95% Cl 2.2-7.0), and 12.0% (95% Cl 10.9-13.1) of the participants, respectively. Women were significantly more likely than men to be seropositive for lgM antibodies (Mantel-Haenszel summary odds ratio = 1.85, 95% Cl 1.34-2.57). Seropositivity for lgM antibodies to H. pylori was found less often with increasing age. An lgG antibody response was not seen in 23.7% of cases with overall increased antibodies to H. pylori. Increased levels of lgG or lgA antibodies were more frequent in people with a history of peptic ulcer disease. Seroprevalences of increased H. pylori antibodies are high in unselected populations. Primary H. pylori infections are contracted at all ages, but infection rates decline with age. Inclusion of measurements of lgA and lgM antibody levels in future screening for H. pylori may improve the diagnostic sensitivity of serologic analyses.