Association of serum pepsinogens and gastrin-17 with Helicobacter pylori infection assessed by urea breath test

Abstract

BackgroundAssociation of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti-Helicobacter pylori IgG antibody have been extensively studied. However, the association of serum pepsinogen and gastrin-17 with H. pylori infection has not been studied in a large population.AimTo investigate the impact of H. pylori infection on serum levels of pepsinogens and gastrin-17.MethodsA total of 354, 972 subjects who underwent health check-ups were included. Serum levels of pepsinogens and gastrin-17 were measured using the enzyme-linked immunosorbent assay. H. pylori infection was detected using 14C-urea breath test (UBT). Multivariable logistic regression analysis was used to investigate the association of serum pepsinogen and gastrin-17 with H. pylori infection.ResultsH. pylori prevalence was 33.18% in this study. The mean levels of pepsinogens and gastrin-17 were higher, while the mean pepsinogen-I/II ratio were lower among H. pylori-positive than -negative subjects. In H. pylori-positive subjects, pepsinogen and gastrin-17 levels correlated positively, whereas the pepsinogen-I/II ratio correlated negatively with UBT values (e.g., the mean serum level of pepsinogen-I in subjects with UBT values in the range of 100-499dpm, 500-1499dpm, and ≥1500dpm was 94.77 ± 38.99, 102.77 ± 43.59, and 111.53 ± 47.47 ng/mL, respectively). Compared with H. pylori-negative subjects, the adjusted odds ratio (aOR) of having pepsinogen-I ≤ 70 ng/mL in the three H. pylori-positive but with different UBT value groups was 0.31 (p<0.001), 0.16 (p<0.001), and 0.08 (p<0.001), respectively; while the aOR of having G-17>5.70 pmol/L was 4.56 (p<0.001), 7.43 (p<0.001), and 7.12 (p<0.001). This suggested that H. pylori-positive subjects with higher UBT values were less likely to have pepsinogen-I ≤70 ng/mL (a serum marker for gastric atrophy), but more likely to have gastrin-17 >5.70 pmol/L (a marker for peptic ulcer).ConclusionsH. pylori-positive subjects with higher UBT values are unlikely to have gastric atrophy, but may have greater risk of severe gastritis or peptic ulcers. Our study suggests that H. pylori-positive patients with high UBT values may benefit the most from H. pylori eradication.

A Study on the Feasibility of Optimizing Gastric Cancer Screening to Reduce Screening Costs in China Using a Gradient Boosting Machine: A prospective, large-sample, single-center study

“…pylori infection can lead to secondary hypergastrinemia and hyperpepsinogenemia, indicating that both G-17 and PG I/II levels can re ect the presence of H. pylori infection to some extent [25][26][27]. Studies have shown that PG I and PG II levels are associated with H. pylori infection; furthermore, a close relationship between G-17 and H. pylori, as patients with H. pylori infection have signi cantly higher levels of G-17 than those without infection [28,29]. This suggests that G-17, PG I, and PG II are associated with H. pylori infections.…”

“…This suggests that G-17, PG I, and PG II are associated with H. pylori infections. As H. pylori-induced gastritis is the most common condition, these three markers not only re ect the overall gastric function but also indirectly indicate the presence of H. pylori infection in the body [23,29].…”

Investigation of the prevalence and risk factors of Helicobacter pylori infection and the value of different gastric cancer screening methods in a low-risk region of gastric cancer in China

“…Many studies have also found that H. pylori -positive patients have significantly higher PG II levels than H. pylori -negative patients, so it can be used as a marker of active H. pylori infection [ 25–27 ]. Zhou JP also found that the level of G-17 in patients with H. pylori infection was significantly higher [ 19 ]. This is consistent with our findings.…”