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The prevalence and associated factors of autoimmune gastritis: single-center, hospital-based prospective study in
Meixuan Li1, Yu Huang1, Xiao Liang1
1Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 145 Middle Shandong Road, Shanghai, 200001, China.
Background:
Autoimmune gastritis (AIG) is a chronic immune-mediated disease characterized by anti-parietal cell antibody (PCA) and corpus-predominant atrophy. However, epidemiological data on AIG remain limited in China where the prevalence of Helicobacter pylori (H. pylori) is high. This study aimed to estimate the prevalence and associated factors of AIG in a hospital-based population.
Methods:
This study enrolled subjects who underwent the first upper gastrointestinal endoscopy at Renji Hospital from August 2023 to August 2025. All participants received serological tests and histopathological evaluation, and demographic information and medical history were recorded. Individuals with prior history of H. pylori eradication were excluded. AIG was diagnosed by PCA positivity with corpus-dominant atrophy and/or intestinal metaplasia, regardless of H. pylori status.
Results:
A total of 1378 subjects (mean age 53.7 years, 56.7% female) were included. The positive rates of PCA and IFA were 12.6% and 1.4%, respectively. Compared with PCA-negative individuals, PCA-positive subjects had significantly lower H. pylori infection rates and higher frequencies of coexisting autoimmune diseases, particularly autoimmune thyroid diseases (AITD). Overall, 54 subjects (3.9%) met the diagnostic criteria for AIG (mean age 56.3 years, 70.4% female), with 29.6% anemia, 27.8% coexisting AITD. Among AIG patients, intestinal metaplasia was present in 81.5%, pseudo-pyloric metaplasia in 42.6%, gastric neuroendocrine cell hyperplasia in 27.8%, and fundic gland polyps in 11.1%.
Conclusion:
This study provides a comprehensive estimate of AIG prevalence in Chinese population, identifying key associated factors, offering valuable data for early screening and risk assessment of AIG.
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