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Riesgo de colangitis esclerosante primaria entre pacientes con gastritis: estudio de cohorte a nivel nacional
Lina Lindström Älgå1, Isabella Ekheden2,3, Marcus Thuresson4
1Department of Medicine Huddinge MedH, Karolinska Institutet, Stockholm, Sweden. lina.lindstrom@ki.se.
European journal of epidemiology
|August 23, 2025
Resumen
El riesgo de colangitis esclerosante primaria (CSP) está moderadamente aumentado en pacientes con gastritis. Sin embargo, esta asociación desaparece cuando se compara con individuos con mucosa gástrica normal, lo que sugiere un vínculo gastrointestinal no específico.
Área de la Ciencia:
- Hepatología
- Gastroenterología
- Enfermedades autoinmunes
Sus antecedentes:
- La colangitis esclerosante primaria (CSP) es una enfermedad hepática autoinmune grave con una patogénesis en gran medida desconocida.
- La infección por Helicobacter pylori (H. pylori) y la gastritis son desencadenantes potenciales de la CFP debido a la prevalencia de H. pylori en la enfermedad hepática crónica.
- El riesgo específico de PSC en pacientes con infección por H. pylori o gastritis sigue siendo indeterminado.
Objetivo del estudio:
- Investigar la relación entre la gastritis y la hepatitis. la infección por pylori y el riesgo subsiguiente de desarrollar PSC.
- Determinar si la infección por H. pylori o la gastritis actúan como un desencadenante específico para el desarrollo de la CPS.
Principales métodos:
- Estudio de cohorte nacional de personas suecas sometidas a gastroscopia con biopsia entre 1990 y 2017.
- Se incluyeron pacientes con gastritis (n=306.588) o H. pylori (n=11.890).
- Se utilizaron tres grupos de control: población general (n=1,544,667), mucosa gástrica normal (n=318,754) y controles hermanos (n=231,879).
- Relaciones de riesgo calculadas (RR) para las CPS, ajustadas por múltiples covariables.
Principales resultados:
- Los pacientes con gastritis o H. pylori mostraron una mayor probabilidad de diagnóstico de CPS.
- En comparación con la población general, los pacientes con gastritis tenían una HR totalmente ajustada de 3,35 (95% IC 2,67 a 4,20) para la CFP.
- Sin embargo, en comparación con los individuos con mucosa gástrica normal, el riesgo de PSC no se incrementó significativamente en los pacientes con gastritis.
Conclusiones:
- El diagnóstico de gastritis a través de la gastroscopia se asocia con un riesgo moderadamente mayor de CPS en el futuro.
- Esta asociación no se observa cuando se compara con individuos sometidos a tratamiento gastrointestinal con hallazgos normales.
- El vínculo entre la gastritis y la CFP puede ser no específico, potencialmente relacionado con otros trastornos gastrointestinales.
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