{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:19:59Z","timestamp":1780467599636,"version":"3.54.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK056338"],"award-info":[{"award-number":["DK056338"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["CIN 13-413"],"award-info":[{"award-number":["CIN 13-413"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic alcohol use is a risk factor for non-cardia gastric adenocarcinoma. However, it is less well understood whether alcohol use is a risk factor for premalignant mucosal changes, namely gastric intestinal metaplasia. We examined the association between various parameters of alcohol use and risk of gastric intestinal metaplasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from 2084 participants (including 403 with gastric intestinal metaplasia) recruited between February 2008-August 2013 into a cross-sectional study at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas. All participants underwent a study upper endoscopy with systematic gastric mapping biopsies. Cases had intestinal metaplasia on any non-cardia gastric biopsy. Participants self-reported lifetime history of alcohol consumption, along with other lifestyle risk factors, through a study survey. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for categories of average alcohol consumption using multivariable logistic regression, and restricted cubic spline regression to explore the potential shape of a dose-response relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to lifelong non-drinkers, individuals who consumed on average \u226528 drinks per week had no elevated risk for gastric intestinal metaplasia (adjusted OR, 1.27; 95% CI, 0.74\u20132.19). Based on a spline regression curve and its 95% CI, there was also no demonstrable association between cumulative lifetime alcohol consumption and risk of gastric intestinal metaplasia. Similarly, we found no association between beverage type (beer, wine, liquor\/spirits) and risk for gastric intestinal metaplasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neither amount of alcohol consumed nor specific beverage type was associated with risk of gastric intestinal metaplasia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0260019","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T13:25:53Z","timestamp":1636982753000},"page":"e0260019","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Alcohol consumption and the risk of gastric intestinal metaplasia in a U.S. Veterans population"],"prefix":"10.1371","volume":"16","author":[{"given":"Hudson M.","family":"Holmes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre G.","family":"Jove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6113-4780","authenticated-orcid":true,"given":"Mimi C.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashem B.","family":"El-Serag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0084-5308","authenticated-orcid":true,"given":"Aaron P.","family":"Thrift","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"issue":"6","key":"pone.0260019.ref001","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"pone.0260019.ref002","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.gtc.2016.04.002","article-title":"Current Perspectives on Gastric Cancer","volume":"45","author":"JM Marqu\u00e9s-Lespier","year":"2016","journal-title":"Gastroenterol Clin North Am"},{"issue":"24","key":"pone.0260019.ref003","first-page":"6735","article-title":"Human gastric carcinogenesis: a multistep and multifactorial process\u2014First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention","volume":"52","author":"P Correa","year":"1992","journal-title":"Cancer Res"},{"issue":"2","key":"pone.0260019.ref004","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1440-1746.2008.05774.x","article-title":"Intestinal metaplasia: A premalignant lesion involved in gastric carcinogenesis","volume":"24","author":"RA Busuttil","year":"2009","journal-title":"J Gastroenterol Hepatolog"},{"issue":"3","key":"pone.0260019.ref005","doi-asserted-by":"crossref","first-page":"G626","DOI":"10.1152\/ajpgi.2001.281.3.G626","article-title":"Nitric oxide in gastrointestinal epithelial cell carcinogenesis: linking inflammation to oncogenesis","volume":"281","author":"M Jaiswal","year":"2001","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"issue":"9","key":"pone.0260019.ref006","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1136\/gut.2003.034629","article-title":"Factors predicting progression of gastric intestinal metaplasia: results of a randomised trial on Helicobacter pylori eradication","volume":"53","author":"WK Leung","year":"2004","journal-title":"Gut"},{"issue":"19","key":"pone.0260019.ref007","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1093\/jnci\/92.19.1607","article-title":"Gastric Dysplasia and Gastric Cancer: Helicobacter pylori, Serum Vitamin C, and Other Risk Factors","volume":"92","author":"WC You","year":"2000","journal-title":"J Natl Cancer Inst"},{"key":"pone.0260019.ref008","volume-title":"IARC Monographs on the Evaluation of Carcinogenic Risks to Humans","author":"World Health Organization and International Agency for Research on Cancer","year":"1988"},{"issue":"3","key":"pone.0260019.ref009","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/ijc.29411","article-title":"Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study","volume":"137","author":"G Buckland","year":"2015","journal-title":"Int J Cancer"},{"issue":"1","key":"pone.0260019.ref010","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/annonc\/mdr135","article-title":"A meta-analysis on alcohol drinking and gastric cancer risk","volume":"23","author":"I Tramacere","year":"2012","journal-title":"Ann Oncol"},{"issue":"3","key":"pone.0260019.ref011","first-page":"627","article-title":"A prospective study of stomach cancer and its relation to diet, cigarettes, and alcohol consumption","volume":"50","author":"A Nomura","year":"1990","journal-title":"Cancer Res"},{"issue":"2","key":"pone.0260019.ref012","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1093\/annonc\/mdr136","article-title":"A meta-analysis on alcohol drinking and esophageal and gastric cardia adenocarcinoma risk","volume":"23","author":"I Tramacere","year":"2012","journal-title":"Ann Oncol"},{"issue":"3","key":"pone.0260019.ref013","doi-asserted-by":"crossref","first-page":"381","DOI":"10.14309\/ajg.0000000000000498","article-title":"Demographic and Lifestyle Risk Factors for Gastric Intestinal Metaplasia Among US Veterans","volume":"115","author":"MC Tan","year":"2020","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"pone.0260019.ref014","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1111\/j.1572-0241.2001.03773.x","article-title":"Effect of lifestyle, smoking, and diet on development of intestinal metaplasia in H. pylori-positive subjects","volume":"96","author":"A Russo","year":"2001","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"pone.0260019.ref015","first-page":"289","article-title":"Effect of Helicobacter pylori infection, smoking and dietary habits on the occurrence of antrum intestinal metaplasia. Clinico-epidemiological study in Poland","volume":"50","author":"W Jedrychowski","year":"1999","journal-title":"Pol J Pathol"},{"issue":"2","key":"pone.0260019.ref016","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.cgh.2020.03.015","article-title":"Prevalence of Gastric Intestinal Metaplasia in a Multiethnic US Veterans Population","volume":"19","author":"TH Nguyen","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"pone.0260019.ref017","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/ajg.2013.443","article-title":"Association between Helicobacter pylori and Barrett\u02bcs Esophagus: A Case\u2013Control Study","volume":"109","author":"LA Fischbach","year":"2014","journal-title":"Am J Gastroenterol"},{"issue":"10","key":"pone.0260019.ref018","first-page":"1161","article-title":"Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994","volume":"20","author":"MF Dixon","year":"1996","journal-title":"Am J Surg Pathol"},{"issue":"1","key":"pone.0260019.ref019","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s10620-013-2892-6","article-title":"No Significant Effects of Smoking or Alcohol Consumption on Risk of Barrett\u2019s Esophagus","volume":"59","author":"AP Thrift","year":"2014","journal-title":"Dig Dis Sci"},{"key":"pone.0260019.ref020","author":"M Buis","year":"2008","journal-title":"POSTRCSPLINE: Stata module containing post-estimation commands for models using a restricted cubic spline"},{"issue":"5","key":"pone.0260019.ref021","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jclinepi.2008.05.015","article-title":"Quantile regression and restricted cubic splines are useful for exploring relationships between continuous variables","volume":"62","author":"RA Marrie","year":"2009","journal-title":"J Clin Epidemiol"},{"issue":"9","key":"pone.0260019.ref022","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1002\/sim.3841","article-title":"Dose\u2010response analyses using restricted cubic spline functions in public health research","volume":"29","author":"L Desquilbet","year":"2010","journal-title":"Stat Med"},{"issue":"6","key":"pone.0260019.ref023","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10654-011-9554-9","article-title":"Estimating measures of interaction on an additive scale for preventive exposures","volume":"26","author":"MJ Knol","year":"2011","journal-title":"Eur J Epidemiol"},{"key":"pone.0260019.ref024","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1186\/1471-2458-13-600","article-title":"Time characteristics of the effect of alcohol cessation on the risk of stomach cancer\u2014a meta-analysis","volume":"13","author":"J Jarl","year":"2013","journal-title":"BMC Public Health"},{"issue":"11","key":"pone.0260019.ref025","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S1470-2045(09)70326-2","article-title":"A review of human carcinogens\u2014Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish","volume":"10","author":"B Secretan","year":"2009","journal-title":"Lancet Oncol"},{"issue":"10","key":"pone.0260019.ref026","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1002\/ijc.25885","article-title":"Alcohol drinking and esophageal squamous cell carcinoma with focus on light\u2010drinkers and never\u2010smokers: A systematic review and meta\u2010analysis","volume":"129","author":"F Islami","year":"2011","journal-title":"Int J Cancer"},{"issue":"3","key":"pone.0260019.ref027","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1055\/s-2007-1001257","article-title":"Action of pure ethanol and some alcoholic beverages on the gastric mucosa in healthy humans: a descriptive endoscopic study","volume":"30","author":"MR Knoll","year":"1998","journal-title":"Endoscopy"},{"issue":"4","key":"pone.0260019.ref028","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/S1521-6918(03)00049-0","article-title":"Alcohol-related diseases of the oesophagus and stomach","volume":"17","author":"S Teyssen","year":"2003","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"6","key":"pone.0260019.ref029","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/0016-5085(87)90252-6","article-title":"Action of ethanol and some alcoholic beverages on gastric acid secretion and release of gastrin in humans","volume":"93","author":"MV Singer","year":"1987","journal-title":"Gastroenterology"},{"issue":"6","key":"pone.0260019.ref030","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/gut.34.6.843","article-title":"Alcohol and gastric acid secretion in humans","volume":"34","author":"S Chari","year":"1993","journal-title":"Gut"},{"issue":"4","key":"pone.0260019.ref031","doi-asserted-by":"crossref","first-page":"289","DOI":"10.3109\/00365529309090243","article-title":"What Controls Should Be Used in Studies of Acute Effects of Alcohol and Alcoholic Beverages on the Stomach and the Pancreas","volume":"28","author":"ST Chari","year":"1993","journal-title":"Scand J Gastroenterol"},{"issue":"3","key":"pone.0260019.ref032","first-page":"197","article-title":"Effect of ethanol and alcoholic beverages on the gastrointestinal tract in humans","volume":"11","author":"MV Singer","year":"2002","journal-title":"Rom J Gastroenterol"},{"issue":"4","key":"pone.0260019.ref033","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S1521-6918(03)00034-9","article-title":"Effect of alcohol consumption on the gut","volume":"17","author":"C Bode","year":"2003","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"3","key":"pone.0260019.ref034","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/MCG.0b013e3181bb837a","article-title":"Does Daily Alcohol and\/or Cigarette Consumption Cause Low-grade Dysplasia, a Precursor of Esophageal Squamous Cell Carcinoma?","volume":"44","author":"K Kaneko","year":"2010","journal-title":"J Clin Gastroenterol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T02:06:25Z","timestamp":1726106785000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260019"}},"subtitle":[],"editor":[{"given":"Matteo","family":"Rota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0260019","relation":{"has-review":[{"id-type":"doi","id":"10.32388\/1ROEK4","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]}}}