Role of Helicobacter pylori and autoimmunity in serological atrophic corpus gastritis in a Dutch primary care community.
BACKGROUND
Atrophic corpus gastritis predisposes to vitamin B12 deficiency and gastric cancer. Little is known about the seroprevalence of atrophic corpus gastritis in the general population of Western Europe.


OBJECTIVE
To investigate the seroprevalence of atrophic corpus gastritis in a West-European primary care community in relation to Helicobacter pylori infection and autoimmunity.


METHODS
Nine hundred and ninety-seven consecutive persons attending one general practice were asked to participate in the study by completing a questionnaire and donating fasting blood. Gastrin, pepsinogen A and C, and antibodies to H. pylori and parietal cells were measured by well-validated immunological methods. Criteria for serological atrophic corpus gastritis were pepsinogen A < 17 microg/l, pepsinogen A/C ratio <1.6, and gastrin >100 ng/l.


RESULTS
Thirty-four participants (3.4%) fulfilled the serological criteria of atrophic corpus gastritis. Twenty-one of them (62%) and 17 of 34 (50%) age-matched and sex-matched nested controls were H. pylori positive [NS; odds ratio, 1.62 (0.62-4.24)], while 15 of them (44%) and one of 34 controls had antibodies to parietal cells [P < 0.005; odds ratio, 24.0 (3.00-201)].


CONCLUSIONS
The seroprevalence of atrophic corpus gastritis in this primary care community is 3.4%. When compared with controls, the approximate relative risk of having atrophic corpus gastritis was significantly higher (P < 0.025) for antibodies to parietal cells (24.0) than to H. pylori (1.62). In view of the decreasing risk of H. pylori infection in the western world, it is likely that the impact of H. pylori on the development of atrophic corpus gastritis will further diminish.
Korstanje
André
A
Department of Gastroenterology, Rijnstate Hospital Arnhem, The Netherlands.
den Hartog
Gijsbert
G
Biemond
Izak
I
Roelandse
Freek W C
FW
Souverijn
John H M
JH
Lamers
Cornelis B H W
CB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D015551:Autoimmunity / Q000502:physiology*; D016022:Case-Control Studies; D005260:Female; D005755:Gastrins / Q000097:blood*; D005757:Gastritis, Atrophic / Q000097:blood* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010295:Parietal Cells, Gastric / Q000276:immunology; D010435:Pepsinogens / Q000097:blood*; D011320:Primary Health Care; D016036:Seroepidemiologic Studies
D000907:Antibodies, Bacterial; D005755:Gastrins; D010435:Pepsinogens