title: Link between Serum Pepsinogen Concentrations and Upper Gastrointestinal Endoscopic Findings.
abstract: The serum pepsinogen (PG) assay findings are correlated with the status of Helicobacter pylori infection, but there are controversies on the link with upper gastrointestinal (UGI) endoscopic findings. The aim of this study was to determine the significance of a serum PG assay for correlating with endoscopic findings in H. pylori-seroprevalent adult population. Korean adults who visited for a health check-up were included consecutively. Subjects after gastrectomy or H. pylori eradication were excluded. After completing the serum PG assay and anti-H. pylori immunoglobulin G (IgG) titer on the same day of UGI endoscopy, subjects with equivocal serology test finding or gastric neoplasm were excluded. Of the 4,830 included subjects, 3,116 (64.5%) were seropositive for H. pylori. Seropositive finding was related to high serum PG I (P < 0.001) and PG II (P < 0.001) concentrations, low PG I/II ratio (P < 0.001), old age (P < 0.001), and male gender (P = 0.006). After adjusting age and gender, the serum PG I and II concentrations were positively correlated with the presence of nodular gastritis (NG) (all P = 0.003). The serum PG I was positively correlated with gastric ulcer (P = 0.003), and it was correlated with duodenal ulcer in seropositive subjects (P = 0.008). The PG I/II ratio was positively correlated with erosive esophagitis, while it was inversely related to chronic atrophic gastritis and metaplastic gastritis (all P < 0.001). Our findings suggest that the serum PG assay finding correlates well with the UGI endoscopic finding. A higher serum PG concentration in subjects with NG and peptic ulcer disease suggests that endoscopic findings reflect gastric secreting ability.
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sang Pyo
authors.identifier: http://orcid.org/0000-0002-4495-3714
authors.initials: SP
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea. sunyoung@kuh.ac.kr.
authors.forename: Sun Young
authors.identifier: http://orcid.org/0000-0003-4146-6686
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jeong Hwan
authors.identifier: http://orcid.org/0000-0002-2503-2688
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: In Kyung
authors.identifier: http://orcid.org/0000-0002-3848-5571
authors.initials: IK
authors.lastname: Sung
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hyung Seok
authors.identifier: http://orcid.org/0000-0003-3141-4858
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Chan Sup
authors.identifier: http://orcid.org/0000-0002-3300-4417
authors.initials: CS
authors.lastname: Shim
mesh_terms: D000328:Adult; D000367:Age Factors; D000907:Antibodies, Bacterial / Q000097:blood; D003430:Cross-Sectional Studies; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis; D016145:Endoscopy, Digestive System; D004797:Enzyme-Linked Immunosorbent Assay; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis; D005260:Female; D005756:Gastritis / Q000150:complications / Q000175:diagnosis; D016481:Helicobacter Infections / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D012737:Sex Factors; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D020116:Pepsinogen A
keywords: Endoscopy; Gastritis; Helicobacter pylori; Pepsinogen; Upper Gastrointestinal