Article Text

PDF
Gastric histology, serological markers and age as predictors of gastric acid secretion in patients infected with Helicobacter pylori
  1. M H Derakhshan1,
  2. E El-Omar1,
  3. K Oien2,
  4. D Gillen1,
  5. V Fyfe1,
  6. J E Crabtree3,
  7. K E L McColl1
  1. 1Department of Medicine and Therapeutics, Western Infirmary, University of Glasgow, Glasgow, UK
  2. 2Department of Pathology, Western Infirmary, University of Glasgow, Glasgow, UK
  3. 3Molecular Medicine Unit, St James’s University Hospital, Leeds, UK
  1. Correspondence to:
 Professor K E L McColl
 Department of Medicine and Therapeutics, Western Infirmary, University of Glasgow, Glasgow G11 6NT, UK; k.e.l.mccoll{at}clinmed.gla.ac.uk

Abstract

Background: Acid secretion is intimately associated with most upper gastrointestinal diseases. Helicobacter pylori infection is a major environmental factor modifying acid secretion.

Aim: To study the association between the pattern of H pylori gastritis and gastric secretory function in a large number of subjects without specific upper gastrointestinal disease.

Methods and materials: Maximal acid output (MAO) was measured in 255 patients with dyspepsia showing normal endoscopy. Activity and severity of gastritis, atrophy and H pylori infection were assessed in body and antral biopsies. The correlations of histological parameters as well as age, sex, height, weight, smoking, serum gastrin, pepsinogen I and II, and their ratio with MAO were determined. Multiple linear regression was used to show the best possible predictors of MAO.

Results: Negative relationships: Body atrophy and body-combined (active and chronic) inflammatory scores showed a potent inverse correlation with MAO (correlation coefficients (CC) 0.59 and 0.50, respectively). Body:antral chronic gastritis ratio and body:antral combined inflammation ratio (both with CC = 0.49) and age (CC = 0.44) were also inversely correlated with MAO. Intestinal metaplasia at both antral and body sites had negative relationships with acid output with CC = 0.23 and 0.20, respectively. Positive relationships: Serum pepsinogen I, body H pylori density:combined inflammation ratio and pepsinogen I:II ratio with CC of 0.38, 0.38 and 0.30, respectively, correlated with MAO. The H pylori density: combined inflammation of both antrum and body positively correlated with MAO (CC = 0.29 and 0.38, respectively). Male sex and patient height also positively correlated with acid output. Modelling showed that body combined inflammatory score, body atrophy, age and serum pepsinogen I are independent predictors of acid output (R2 = 0.62).

Conclusion: Combination of body gastritis, body atrophy, age and serum pepsinogen I can be used as predictors of acid-secretory state in populations infected with H pylori.

  • ANOVA, analysis of variance
  • BMI, body mass index
  • CagA, cytotoxin-associated gene A
  • CIS, combined inflammatory score
  • ECL, enterochromaffin-like
  • IQR, interquartile range
  • MAO, maximal acid output

Statistics from Altmetric.com

Footnotes

  • Published Online First 27 April 2006

  • Competing interests: None declared.

  • This study was approved by the Ethics Committee of the Western Infirmary, Glasgow, UK.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.