An Epidemiological Study on the Relationship between Gastric Mucosal Atrophy, Exhaled Hydrogen Concentration, and Gut...

This study aimed to conduct an epidemiological investigation of the relationship between gastric mucosal atrophy and exhaled hydrogen gas concentration, including gut microbiota, in residents who participated in health checkups.

Based on pepsinogen I <70 ng/mL and PG I/PG II <3 as cutoff values, the participants were divided into a control (n = 903) and atrophy (n = 63) groups. The exhaled hydrogen gas concentrations and gut microbiota were compared in 212 participants from the control group and 53 participants from the atrophy group, selected through propensity score matching. Furthermore, participants were categorized as non-infection, persistent infection, or post-eradication groups based on their Helicobacter pylori (H. pylori) infection status.

In the atrophy group, 66.0% were persistent H. pylori carriers, whereas 39.6% of the control group had undergone H. pylori eradication. The atrophy group showed lower exhaled hydrogen concentration than those of the control group. In the gut microbiota of the atrophy group, an increase in Streptococcus, and a decrease in Blautia were observed. Among H. pylori infection statuses, persistent infection group showed reduced exhaled hydrogen gas concentration and increased gut Streptococcus compared to the non-infection group, but no association was observed with the post-eradication group.

Most individuals infected with H. pylori showed evidence of gastric mucosal atrophy, accompanied by decreased breath hydrogen concentrations and alterations in the gut microbiota. Eradication of H. pylori may ameliorate gastric mucosal atrophy, which could subsequently normalize the gut microbial composition and lead to increased levels of exhaled hydrogen.