S1850 Positive Association of Dietary Salt Intake and Gastric Intestinal Metaplasia: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Introduction: Gastric cancer (GC) is the fourth leading cause of global cancer mortality. Gastric intestinal metaplasia (GIM) is the principal gastric premalignant condition (GPMC) and thought to represent an irreversible histologic point of no return. Dietary salt intake is associated with gastric cancer and is implicated in GIM development and progression. Salt has several carcinogenic effects: the generation of N-nitroso compounds; degradation of the mucosal barrier with inflammation; and increased colonization and inflammation by H. pylori, particularly cagA+ strains. We performed a systematic review and meta-analysis on the association of salt intake and GIM prevalence. Methods: We used the PubMed Scopus and Web of Science databases, with the PRISMA protocol, through April 2023 to identify epidemiological studies published in English assessing the association of salt consumption and the GIM prevalence. Two independent reviewers assessed study quality/risk for bias using Newcastle-Ottawa Scale (NOS) and extracted descriptive and quantitative data. The pooled OR estimates were calculated, heterogeneity was assessed by the inconsistency index (I2). Results: The literature search yielded 3522 studies, of which 36 were identified for full-text review, with 13 studies filling the criteria for final analysis including 9237 patients. The odds ratios (ORs) for the association between salt intake and GIM prevalence ranged from 1.01 to 3.50 across the included studies. The weighted average OR was 1.49 (95%; 1.21-1.84). The test of theta ( = 0) z-value was 3.75, demonstrating a statistically significant association between salt intake and GIM (p < 0.0002). The heterogeneity analysis revealed a moderate level of heterogeneity, with an I2 value of 55.55%, indicating variations in effect sizes across the studies. The regression-based Egger test (P-value = 0.0410) implied potential small-study effects in our meta-analysis (Figure 1). Conclusion: Our findings suggest an association between dietary salt intake and the risk of developing GIM. The association was stronger than that observed in studies with GC as the endpoint. There was no significant difference by geographic region nor by the study design. Salt intake recommendations should be included in overall risk-reduction recommendations (e.g., tobacco, alcohol) in patients with GIM.Figure 1.: Forrest plot of ORs for the association between salt intake and GIM prevalence by geographic regions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.027 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".