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Longitudinal Changes in the Serum Pepsinogen I/II Ratio With Progression of Gastric Atrophy
Soie Chung1,2, Jung Kim3, Ji Hyun Song3
1Department of Laboratory Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
Background:
This study evaluated longitudinal changes in the serum pepsinogen (PG) I/II ratio according to endoscopic gastric mucosal atrophy.
Methods:
We retrospectively analyzed 21,265 participants who underwent endoscopy during health checkups between 2015 and 2023. Longitudinal changes in PG I/II ratio were examined in 2217 subjects with ≥ 2 endoscopies using linear mixed-effects models. Serum PG I, PG II, and Helicobacter pylori IgG were measured. The AG severity was graded endoscopically according to Kimura-Takemoto classification.
Results:
The PG I/II ratio decreased stepwise with advancing Kimura-Takemoto stage. In longitudinal analyses of 2217 participants with repeated endoscopy, within-subject declines in the PG I/II ratio paralleled progression of endoscopic atrophy, with greater reductions in more advanced stages (No atrophy: reference; C2: -0.383; C3: -1.150; O1: -1.412; O2: -2.101; O3: -2.007; all p < 0.001).
Conclusions:
Within-subject declines in the PG I/II ratio were observed with progression of gastric atrophy. Serial measurement of the PG I/II ratio may be useful for monitoring the progression of gastric mucosal atrophy, particularly in patients for whom repeated endoscopic evaluation is not feasible.
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