Assessing the Role of Selenium Levels and Helicobacter pylori Infection in Gastric Intestinal Metaplasia: A Histopathological Study

Purpose: Gastric intestinal metaplasia (IM) is a recognized premalignant lesion in the Correa cascade and a key risk factor for gastric adenocarcinoma. Selenium, an essential trace element with antioxidant and immunomodulatory properties, has been implicated in gastric carcinogenesis, but its association with intestinal metaplasia remains incompletely understood.Material and Methods: This cross-sectional observational study included 114 adult patients who underwent diagnostic upper gastrointestinal endoscopy. Gastric biopsy specimens were evaluated for intestinal metaplasia and atrophy according to the updated Sydney System. Logistic regression analyses were performed to identify factors associated with intestinal metaplasia.Results: Gastric intestinal metaplasia was identified in 23 patients (20.2%). Patients with and without IM were comparable in terms of age, sex, and Helicobacter pylori prevalence. Mean serum selenium levels did not differ significantly between groups; however, selenium deficiency was more frequent in patients with IM (34.8% vs. 12.1%, p=0.024). In multivariable analysis, selenium deficiency was independently associated with intestinal metaplasia (OR 4.01, 95% CI 1.37–11.74, p=0.011), whereas Helicobacter pylori infection was not. Conclusion: Impaired selenium status may contribute to early gastric mucosal alterations and could represent a modifiable risk factor in gastric precancerous conditions.