title: Decrease of serum total ghrelin in extensive atrophic gastritis: comparison with pepsinogens in histological reference.
abstract: OBJECTIVE
  Ghrelin is mainly secreted by the gastric oxyntic mucosa and its production is impaired in chronic atrophic gastritis. This study aimed at evaluating how serum total ghrelin correlates with the extent of atrophy, and to compare its performance as a serologic marker with that of pepsinogen (PG).
  
  
  METHODS
  Data were collected from 154 patients with atrophic gastritis. The histological extent of atrophy was assessed by three paired biopsies from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Fasting serum concentrations of total ghrelin, pepsinogen I and II were measured. Regression analysis was performed to evaluate the factors associated with serum total ghrelin. The serologic performance was compared with that of pepsinogen using receiver-operating characteristic (ROC) curves.
  
  
  RESULTS
  The Helicobacter pylori infection rate was 85%, and extensive atrophic gastritis involving CGC was found in 24%. Serum total ghrelin was significantly decreased in patients with extensive CGC atrophy (median: 170.4 pg/mL, vs 201.1 pg/mL in patients without atrophy; p < 0.001), and its levels correlated with those of pepsinogen I and I/II ratio. The decrease of serum total ghrelin was independent of age, gender, body mass index (BMI), and H. pylori infection status. The sensitivity and specificity of serum total ghrelin in predicting extensive atrophy were 57% and 79%, respectively. The discriminatory ability was similar to that of pepsinogen I/II ratio (p = 0.612), and lower than that of pepsinogen I (p = 0.040).
  
  
  CONCLUSIONS
  Serum total ghrelin is decreased during extensive atrophy involving CGC. The serologic performance is lower than that of pepsinogen I.
authors.affiliation: a Health Screening and Promotion Center , University of Ulsan College of Medicine, Asan Medical Center , Seoul , South Korea .
authors.forename: Suh
authors.initials: S
authors.lastname: Eun Bae
authors.affiliation: b Department of Internal Medicine .
authors.forename: Jeong
authors.initials: J
authors.lastname: Hoon Lee
authors.affiliation: c Department of Pathology , and.
authors.forename: Young
authors.initials: Y
authors.lastname: Soo Park
authors.affiliation: d Department of Clinical Epidemiology and Biostatistics , University of Ulsan College of Medicine, Asan Medical Center , Seoul , South Korea.
authors.forename: Seon
authors.initials: S
authors.lastname: Ok Kim
authors.affiliation: a Health Screening and Promotion Center , University of Ulsan College of Medicine, Asan Medical Center , Seoul , South Korea .
authors.forename: Ji
authors.initials: J
authors.lastname: Young Choi
authors.affiliation: b Department of Internal Medicine .
authors.forename: Ji
authors.initials: J
authors.lastname: Yong Ahn
authors.affiliation: b Department of Internal Medicine .
authors.forename: Do
authors.initials: D
authors.lastname: Hoon Kim
authors.affiliation: b Department of Internal Medicine .
authors.forename: Kee
authors.initials: K
authors.lastname: Don Choi
authors.affiliation: b Department of Internal Medicine .
authors.forename: Ho
authors.initials: H
authors.lastname: June Song
authors.affiliation: b Department of Internal Medicine .
authors.forename: Gin
authors.initials: G
authors.lastname: Hyug Lee
authors.affiliation: a Health Screening and Promotion Center , University of Ulsan College of Medicine, Asan Medical Center , Seoul , South Korea .
authors.forename: Jaewon
authors.initials: J
authors.lastname: Choe
authors.affiliation: c Department of Pathology , and.
authors.forename: Se
authors.initials: S
authors.lastname: Jin Jang
authors.affiliation: b Department of Internal Medicine .
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D005260:Female; D005757:Gastritis, Atrophic / Q000097:blood* / Q000473:pathology*; D054439:Ghrelin / Q000097:blood*; D016481:Helicobacter Infections / Q000097:blood* / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000097:blood; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D011706:Pyloric Antrum / Q000473:pathology; D012372:ROC Curve; D012737:Sex Factors; D013270:Stomach / Q000473:pathology*
chemical_list: D015415:Biomarkers; D054439:Ghrelin; D020115:Pepsinogen C; D020116:Pepsinogen A
keywords: Atrophic gastritis; Helicobacter pylori; ghrelin