Atrophic Changes of Gastric Mucosa Are Caused by Helicobacter pylori Infection Rather Than Aging: Studies in Asymptomatic Japanese Adults

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<jats:title>ABSTRACT</jats:title><jats:p> <jats:bold>Background.</jats:bold>The current study was designed to evaluate the effect of aging and <jats:italic>Helicobacter pylori</jats:italic> infection on the gastric mucosa in asymptomatic Japanese adults.</jats:p><jats:p> <jats:bold>Materials and Methods.</jats:bold>Eighty‐five asymptomatic healthy adults were recruited from a health‐screening center in Sapporo. All subjects underwent endoscopy and gastric biopsy, and serum was obtained for IgG antibodies to <jats:italic>H. pylori</jats:italic>, serum gastrin, and pepsinogen levels.</jats:p><jats:p> <jats:bold>Results.</jats:bold>The prevalence of atrophic change of the gastric mucosa assessed by pathological findings increased with age (49% in the 30‐ to 39‐year‐old group compared to 89% in those 60 years and older, <jats:italic>p</jats:italic> < .001). The frequency of intestinal metaplasia also increased with age (38% in the 30‐ to 39‐year‐old group compared to 82% in those 60 years and older, <jats:italic>p</jats:italic> < .001). In contrast, the frequency of atrophic gastritis and intestinal metaplasia was extremely low in the <jats:italic>H. pylori</jats:italic> seronegative group regardless of age. Mean serum gastrin level in <jats:italic>H. pylori</jats:italic>‐positive adults was significantly greater than in those who were <jats:italic>H. pylori</jats:italic>‐negative (114.3 ± 11.2 compared to 65.8 ± 6.5 pg/ml, <jats:italic>p</jats:italic> < .03). The serum pepsinogen I‐II ratio was significantly lower in those with <jats:italic>H. pylori</jats:italic> infection than in those without (3.1 compared to 6.6, <jats:italic>p</jats:italic> < .0001).</jats:p><jats:p> <jats:bold>Conclusions.</jats:bold>These results suggest that the chronological changes in the gastric mucosa in Japanese individuals are either entirely related to <jats:italic>H. pylori</jats:italic> infection or the process is greatly accelerated by <jats:italic>H. pylori</jats:italic> infection.</jats:p>

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