[Relationship between pepsinogen I/II ratio and age or upper gastrointestinal diseases in Helicobacter pylori-positive and -negative subjects].
OBJECTIVE
Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status.


METHODS
A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay.


RESULTS
H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis).


CONCLUSIONS
Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.
Paik
Chang Nyol
CN
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Chung
In-Sik
IS
Nam
Kwan Woo
KW
Kwon
Jung Hyun
JH
Chang
Jae Hyuck
JH
Suh
Jung Pil
JP
Park
Jae Myung
JM
Cho
Yu Kyung
YK
Lee
In Seok
IS
Kim
Sang Woo
SW
Choi
Myung-Gyu
MG
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004381:Duodenal Ulcer / Q000382:microbiology; D004942:Esophagitis, Peptic / Q000382:microbiology; D005260:Female; D005757:Gastritis, Atrophic / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D013276:Stomach Ulcer / Q000382:microbiology
D020115:Pepsinogen C; D020116:Pepsinogen A