Serum pepsinogen II levels are doubled with Helicobacter pylori infection in an asymptomatic population of 40,383 Chinese subjects

Abstract

Pepsinogen (PG) I and II are crucial in the gastric digestive processes. This study is to examine the relationship of serum PGI, PGII, and PGI/PGII ratio with Helicobacter pylori (Hp) infection, age, sex, and body mass index (BMI) in subjects in Beijing, China. A total of 40,383 asymptomatic subjects, who underwent medical examination in Beijing Rehabilitation Hospital, were included in this study. Serum PG levels were measured using chemoluminescence techniques. The age, sex, and BMI data were collected, and Hp infection was identified with 13 C-urea breath test. Statistical analysis was conducted with Python, Pandas and Seaborn software. Asymptomatic subjects with Hp infection (Hp+) had a significantly higher level of PGI in the serum (111 ng/mL [median]) than those without Hp infection (Hp−) (94 ng/mL, P < .001). The asymptomatic Hp+ subjects had 2-fold higher PGII levels (7.2 ng/mL) than Hp− subjects (3.2 ng/mL, P < .001). These changes produced significantly lower PGI/II ratio in Hp+ patients than in Hp− subjects (16:30, P < .001). The serum PGI and PGII levels were higher in males than in females (PGI: 104 ng/mL vs 95 ng/mL, PGII: 4.3 ng/mL vs 3.7 ng/mL, both P < .001), PGI/II ratio of males is at 95% of that in females ( P < .001). PGI and PGII levels gradually increased in older people ( P < .001), whereas the PGI/II ratio decreased significantly with age ( P < .001). The levels of the two serum PGs were decreased and the ratio increased when BMI were higher than 28 kg/cm 2 ( P < .05). The levels of serum PGI, especial PGII, were increased by Hp infection, and also influenced by age, sex, and BMI. Therefore, these influencing factors should be considered during clinical practice.

Analysis of gastrin‐17 and its related influencing factors in physical examination results

“…H. pylori is considered as a primary carcinogen 12 . According to the studies about H. pylori infection carried out in China, in H. pylori ‐positive patients, the serum levels of G17, PGI and PG II increase, especially PGII, while the ratio of PGI/PGII decreases 13 . This study identified that the level of G17 in H. pylori ‐positive subjects was remarkably higher than that in H. pylori ‐negative subjects, coinciding with another study 14 .…”

“…12 According to the studies about H. pylori infection carried out in China, in H. pylori-positive patients, the serum levels of G17, PGI and PG II increase, especially PGII, while the ratio of PGI/PGII decreases. 13 This study identified that the level of G17 in H. pylori-positive subjects was remarkably higher than that in H. pylorinegative subjects, coinciding with another study. 14 Patients with H. pylori infection and low PGI/PGII ratio are confronted with a higher risk of gastric cancer, and thus secondary diagnosis (endoscopy and histology) should be performed.…”

“…Subjects underwent the 13 C breath test early in the morning on an empty stomach. The test was implemented using the kit produced by Shenzhen Zhonghe Headway Bio-Sci & Tech Co., Ltd., and the HCBT-02 13 C breath test instrument.…”

Reference Ranges of Serum Pepsinogens on Two Platforms in the Chinese Population

“…2, the levels of PG-I measured by CLIA increased with age but gradually decreased after age 60, similar to Sun's ndings [20]. However, the levels of PG-I measured by ELISA consistently increased with age, similar to Hong's results [22]. Although serum pepsinogen concentrations were well correlated with acid secretion [25], the effect of age on gastric acid secretion is controversial.…”

Performing the ABC Method Twice for Gastric Cancer Risk Stratification: A Retrospective Study Based on Data from a Large-Scale Screening Facility

“…It has been reported that PGI and II are increased and PGI/PGII is decreased in patients with H. pylori infection, and that PGI and PGII are decreased and PGI/PGII is increased after the eradication of H. pylori . [ 27 , 28 ] In this study, the PG I and II levels of the 11 participants with new H. pylori infections tended to increase after infection; however, the difference in PG levels was not significant. In addition, the results indicated that PG I/PG II significantly decreased after infection (PG I: 71.7 ± 7.47 in 2010 and 78.7 ± 11.0 in 2015, p = 0.61; PG II: 10.3 ± 1.49 in 2010 and 21.6 ± 5.79 in 2015, p = 0.07; and PG I/PG II: 7.49 ± 0.83 in 2010 and 4.31 ± 0.30 in 2015, p < 0.01).…”