RELATIONSHIP OF HELICOBACTER-PYLORI TO SERUM PEPSINOGENS IN AN ASYMPTOMATIC JAPANESE POPULATION

A seroepidemiologic study of the prevalence of Helicobacter pylori infection in Japan was performed, and the relationship between serum pepsinogen I and II levels (markers of gastritis and gastric atrophy) and H. pylori infection was investigated. Four hundred and eighteen asymptomatic children and adults were studied. The prevalence of anti-H. pylori immunoglobulin G antibody increased with age. For persons born after 1950, the frequency of H. pylori infection increased at approximately 1% per year; for those born before 1950 the prevalence was high (70%-80%) and relatively constant. Serum pepsinogen I and II levels were significantly higher in H. pylori-infecled volunteers than in H. pylori-uninfected volunteers [51.6 ± 3 vs. 42.9 ± 2 ng/mL (P < 0.05) for pepsinogen I; 16.0 ± 1 vs. 7.5 ± 0.8 ng/mL (P < 0.001) for pepsinogen II]. The ratio of pepsinogen I to pepsinogen II was significantly lower in H. pylori-infected volunteers (3.5 ± 0.2) than in uninfected volunteers (6.3 ± 0.3; P < 0.001). The apparent decrease in prevalence of H. pylori accompanying the Westernization of Japan may eventually be accompanied by a reduction in the frequency of atrophic gastritis, the precursor lesion of the epidemic form of gastric carcinoma, and ultimately result in a decrease in the incidence of gastric carcinoma in Japan. © 1992.