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

Background: Association of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti- IgG antibody have been extensively studied. However, the association of serum pepsinogen and gastrin-17 with infection has not been studied in a large population.

Aim: To investigate the impact of infection on serum levels of pepsinogens and gastrin-17.

Methods: A 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 infection was detected using C-urea breath test (UBT). Multivariable logistic regression analysis was used to investigate the association of serum pepsinogen and gastrin-17 with infection.

Results: 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 -positive than -negative subjects. In -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 -negative subjects, the adjusted odds ratio (aOR) of having pepsinogen-I ≤ 70 ng/mL in the three -positive but with different UBT value groups was 0.31 (<0.001), 0.16 (<0.001), and 0.08 (<0.001), respectively; while the aOR of having G-17>5.70 pmol/L was 4.56 (<0.001), 7.43 (<0.001), and 7.12 (<0.001). This suggested that -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).

Conclusions: -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 -positive patients with high UBT values may benefit the most from eradication.