title: Fasting gastric pH of Japanese subjects stratified by IgG concentration against Helicobacter pylori and pepsinogen status.
abstract: BACKGROUND
  The clinical significance of Helicobacter pylori antibody titer has been controversial, and the association between the extent of gastric atrophy or acid secretion and H. pylori antibody concentration has not been elucidated.
  
  
  METHODS
  Serum pepsinogen, H. pylori antibody concentration, and fasting gastric pH (as an indicator of acid secretion) were measured in 231 patients undergoing upper gastrointestinal endoscopy. "Atrophic" pepsinogen was defined as pepsinogen-I < 70 ng/mL and pepsinogen-I/II ratio < 3. Other levels of pepsinogen were defined as "normal". Fasting gastric pH was analyzed in subjects stratified by pepsinogen level and by H. pylori antibody concentration.
  
  
  RESULTS
  Helicobacter pylori antibody concentration showed no significant relationship with fasting gastric pH when all subjects were analyzed together. In H. pylori-seronegative subjects, fasting gastric pH was within the normal range, irrespective of the extent of mucosal atrophy. In H. pylori-seropositive subjects, H. pylori antibody concentration was positively correlated with fasting gastric pH in subjects with "normal" pepsinogen, but inversely correlated in those with "atrophic" pepsinogen. Particularly in subjects with low H. pylori antibody concentration and atrophic mucosa, a group reportedly at high risk of noncardia cancer, the most impaired acid secretion was shown among subjects with atrophic mucosa.
  
  
  CONCLUSIONS
  The relationship between acid secretion and H. pylori antibody concentration differs depending on the presence of mucosal atrophy. Our findings provide a possible rationalization for measuring both serum pepsinogen levels and H. pylori antibody concentration in gastric cancer screening.
authors: Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Chiba 272-8513, Japan .kisikawa@tdc.ac.jp
authors: Hiroshi
authors: H
authors: Kishikawa
authors: Jiro
authors: J
authors: Nishida
authors: Hitoshi
authors: H
authors: Ichikawa
authors: Shogo
authors: S
authors: Kaida
authors: Sakiko
authors: S
authors: Takarabe
authors: Takashi
authors: T
authors: Matsukubo
authors: Soichiro
authors: S
authors: Miura
authors: Tetsuo
authors: T
authors: Morishita
authors: Toshifumi
authors: T
authors: Hibi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D044466:Asian People; D001284:Atrophy; D055088:Early Detection of Cancer / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D005215:Fasting; D005260:Female; D005750:Gastric Juice / Q000737:chemistry*; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D020116:Pepsinogen A