SEROEPIDEMIOLOGY OF GASTRITIS IN JAPANESE AND DUTCH MALE EMPLOYEES WITH AND WITHOUT ULCER DISEASE

Objective: To explore the state of the gastric mucosa in individuals w ith and without peptic ulcer disease from populations with contrasting peptic ulcer risks. Design: Pepsinogen A, pepsinogen C, gastrin and H elicobacter pylori antibodies are serological markers of gastritis. A decreasing pepsinogen A-C ratio and pepsinogen A level are known to re flect an increasing severity of corpus atrophy, whereas gastrin levels decrease with an increasing severity of antral atrophy when corpus at rophy is present. Helicobacter pylori-positive men, with and without a peptic ulcer history, were the focus of the study. Methods: In 190 Ja panese and 425 Dutch male employees, of similar age (mean age 49 years ) and level of occupation, fasting serum samples were analysed in the same laboratory for Ige antibodies to H, pylori, pepsinogen A, pepsino gen C and gastrin. Any history of ulcer disease was verified through c ase notes. Results: The H. pylori seropositivity rate was higher in th e Japanese men (72%) than in the Dutch (33%). There were 23 (12%) Japa nese and 18 (4%) Dutch men with a verified duodenal ulcer history, and 14 (7%) Japanese and two (0.5%) Dutch men with a verified gastric ulc er history. H. pylori-positive men with a duodenal ulcer history diffe red from the H. pylori-positive men without an ulcer history in that t hey had a significantly higher mean pepsinogen A level (64 and 51 mu g /l in Japanese men and 71 and 57 mu g/l in Dutch men) and also a highe r mean pepsinogen A-C ratio, whereas pepsinogen C and gastrin levels d id not differ. In H. pylori-positive gastric ulcer patients the mean g astrin level was significantly lower than in H. pylori-positive men wi thout ulcer disease (17 and 37 pmol/l in Japanese men), whereas pepsin ogen levels were similar. Conclusion: This study suggests that in H. p ylori-positive duodenal ulcer patients there is less mucosal atrophy o f the corpus and in H. pylori-positive gastric ulcer patients more atr ophy of the antrum than in H. pylori-positive individuals without pept ic ulcer disease.