Korean J Gastroenterol.  2007 Aug;50(2):84-91.

Relationship between Pepsinogen I/II Ratio and Age or Upper Gastrointestinal Diseases in Helicobacter pylori-positive and -negative Subjects

• Paik CN
• Chung IS
• Nam KW
• Kwon JH
• Chang JH
• Suh JP
• Park JM
• Cho YK
• Lee IS
• Kim SW
• Choi MG

Abstract

BACKGROUND/AIMS: 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, p<0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p<0.001) 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 (p<0.001, 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, p<0.005). 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). CONCLUSION: Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.

Keyword

Pepsinogen; Helicobacter pylori; Upper gastrointestinal disease; Age

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Diagnosis, Differential
Duodenal Ulcer/microbiology
Esophagitis, Peptic/microbiology
Female
Gastritis, Atrophic/microbiology
Gastrointestinal Diseases/*diagnosis/*microbiology
Helicobacter Infections/*diagnosis
*Helicobacter pylori/isolation & purification
Humans
Male
Middle Aged
Pepsinogen A/*blood
Pepsinogen C/*blood
Stomach Ulcer/microbiology