title: The Impact of Gastric Atrophy on the Incidence of Diabetes.
abstract: Gastric atrophy results in lower plasma ghrelin, higher gastrin secretion, a change in gut microbiota, and altered dietary nutrient absorption, which may be associated with the incidence of diabetes. Helicobacter pylori (H. pylori) infection is a major cause of gastric atrophy and is associated with diabetes in some reports. Since there is no study which investigates the impact of gastric atrophy on diabetes, we conduct a prospective cohort study to examine the relationship between H. pylori infection, gastric atrophy, and incident diabetes. In this study, subjects with gastric atrophy had a lower risk of incident diabetes, compared to those without gastric atrophy. The extent of gastric atrophy, measured by serum pepsinogen (PG) I/II ratio, was correlated with age, H. pylori IgG titer, HOMA2-IR, and HOMA2%B. When gastric atrophy is more extensive, presented as a lower serum PG I/II ratio, the risk of incident diabetes is lower. On the other hand, there was no significant association between H. pylori infection and the incidence of diabetes. In conclusion, the presence and the extent of gastric atrophy, but not H. pylori infection, are associated with incident diabetes. Further studies are needed to investigate the detailed mechanisms and the potential applications of the findings to guide diabetes screening and treatment strategies.
authors.affiliation: Health Management Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Tse-Ya
authors.initials: TY
authors.lastname: Yu
authors.affiliation: Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Jung-Nan
authors.initials: JN
authors.lastname: Wei
authors.affiliation: Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan.
authors.forename: Chun-Heng
authors.initials: CH
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jyh-Ming
authors.initials: JM
authors.lastname: Liou
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Mao-Shin
authors.initials: MS
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shyang-Rong
authors.initials: SR
authors.lastname: Shih
authors.affiliation: Division of Clinical Pathology' National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
authors.forename: Cyue-Huei
authors.initials: CH
authors.lastname: Hua
authors.affiliation: Division of Clinical Pathology' National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
authors.forename: Yenh-Chen
authors.initials: YC
authors.lastname: Hsein
authors.affiliation: Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Hsu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.affiliation: Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Mei-Kuei
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Ching-Hsiang
authors.initials: CH
authors.lastname: Hsiao
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000453:epidemiology*; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology