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ABC Classification Is Less Useful for Older Koreans Born before 1960.

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Pseudo group A subjects, defined as seronegative without gastric atrophy, were identified in 22.2% of cases. Older age and earlier birth year are risk factors for pseudo group A, with current H. pylori infection linked to gastric secretory ability.

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Area of Science:

  • Gastroenterology
  • H. pylori research
  • Endoscopy

Background:

  • The ABC classification system categorizes individuals based on gastric findings.
  • Group A in this system comprises seronegative subjects without gastric corpus atrophy.
  • Identifying pseudo group A subjects is crucial for accurate classification.

Purpose of the Study:

  • To determine the prevalence of pseudo group A subjects.
  • To characterize the risk factors associated with pseudo group A classification.
  • To investigate the relationship between H. pylori infection and pseudo group A status.

Main Methods:

  • Serum anti-Helicobacter pylori immunoglobulin G (IgG) and pepsinogen (PG) assays were performed on consecutive Korean adults undergoing endoscopy.
  • Past H. pylori infection was defined by eradication history or specific endoscopic findings.
  • Risk factors for pseudo group A classification were analyzed using logistic regression.

Main Results:

  • Out of 2,620 group A subjects, 17.1% had eradication history and 5.1% showed endoscopic signs of past infection.
  • Older age (over 50.5 years) and earlier birth year (before 1959.5) were independent risk factors for pseudo group A.
  • Current H. pylori infection was detected in 3.1% and correlated with higher PG I and PG II levels.

Conclusions:

  • Approximately 22.2% of group A subjects exhibited characteristics of pseudo group A.
  • Individuals over 50, particularly those born before 1960, have a higher risk of being misclassified.
  • Current H. pylori infection is associated with increased gastric secretory capacity.