PWE-172 Micronutrient-Antioxidant Supplementation has no Impact on Gastric Atrophy in Zambian Adults: A Randomised Controlled Trial

Abstract

Background and objectives: We set out to investigate the possibility preventing gastric cancer by reversing atrophy, using micronutrient‐antioxidant supplementation. Methods: Archival samples from a randomised controlled trial, (Kelly et al, Trans R Soc Trop Med Hyg. 2008;102:194‐ 9) were used in this study. In this trial, 500 healthy volunteers were randomly allocated to either a micronutrient‐antioxidant supplementation or placebo. The supplements contained vitamins, A, B1, B2, B6, B12, C, D3, E, niacin, folic acid, iron, zinc, copper and selenium, in quantities 1.5‐2 times the daily requirements. We analysed 215 archival samples, from subjects who had taken either supplementation or placebo for a median of 19 (range 14 to 27) months. Gastric atrophy was determined using pepsinogen 1 to 2 ratio of less than 3.0 and compared between the two groups. Also analysed were the effect of HIV infection, age, body mass index (BMI), smoking, alcohol intake and gastric pH. Results: Gastric atrophy was found in 8 (7.8%) of 103 subjects on supplementation, and 7 (6.3%) of 112 on placebo (RR 1.24; 95%CI 0.47‐3.3; P=0.22). HIV infection was diagnosed in 5 participants with atrophy and 61 without (RR 1.07; 95%CI 0.37‐3.2; P=1.0). The lack of effect of supplementation on atrophy was not changed after stratification for HIV status (M‐H OR 2.0; P= 09.20). Gastric atrophy was found to be more prevalent in those above the age of 40 years, P=0.02 (CI 0.09‐0.84). BMI, smoking, alcohol intake showed no impact on gastric atrophy. Conclusions: An average of 19 months of micronutrientantioxidant supplementation has no impact on gastric atrophy in Zambian adults. The high gastric pH seen in HIV patients cannot be attributed to gastric atrophy.