{
  "abstract": "Background Metabolic factors, particularly body mass index (BMI), have been increasingly implicated in gastrointestinal diseases; however, their relationship with structural gastric precancerous lesions such as atrophy and intestinal metaplasia (IM) remains unclear, especially in populations with high rates of Helicobacter pylori eradication. This study aimed to evaluate the association between BMI and histologic gastric precancerous changes, and to determine whether metabolic phenotype reflects structural mucosal damage.Methods We conducted a cross-sectional study of 111 patients undergoing upper gastrointestinal endoscopy with targeted biopsies for histologic assessment of gastric atrophy and IM. BMI was categorized using an Asian-specific cutoff (≥23 vs <23 kg/m 2). Multivariable logistic regression was performed to evaluate the association between BMI and moderate-to-severe gastric atrophy and IM, adjusting for age, sex, and Helicobacter pylori status.Results BMI ≥23 kg/m 2 was independently associated with a lower likelihood of moderate-to-severe gastric atrophy (adjusted OR = 0.34, 95% CI 0.15-0.80) and intestinal metaplasia (adjusted OR = 0.36, 95% CI 0.15-0.85). No positive association was observed between increased BMI and histologic severity of gastric mucosal damage. This inverse association remained consistent across Helicobacter pylori status subgroups.Conclusions In the post-Helicobacter pylori era, higher BMI does not correspond to increased histologic severity of gastric precancerous lesions. Metabolic phenotype may not be a reliable surrogate for structural gastric damage, highlighting the need for direct mucosal assessment in risk stratification. These findings suggest that gastric carcinogenesis pathways related to mucosal atrophy may differ fundamentally from obesity-related gastrointestinal risk mechanisms.",
  "authors": [
    {
      "affiliations": [
        "Tam Anh General Hospital, Vietnam"
      ],
      "name": "Trung Huynh Van"
    },
    {
      "affiliations": [
        "Tam Anh General Hospital, Vietnam"
      ],
      "name": "Tung Pham Huu"
    },
    {
      "affiliations": [
        "Tam Anh General Hospital, Vietnam"
      ],
      "name": "Long Doan Hoang"
    },
    {
      "affiliations": [
        "Tam Anh General Hospital, Vietnam"
      ],
      "name": "Hung Do Minh"
    }
  ],
  "title": "IDDF2026-ABS-0351 Metabolic phenotype does not reflect histologic severity of gastric precancerous lesions in the post-helicobacter pylori era",
  "uid": "8ccf2ed8-7fee-55b4-ac19-3bbef890e9e0"
}