ABC Classification Is Less Useful for Older Koreans Born before 1960

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.