DETERMINANTS OF PLASMA PEPSINOGEN LEVELS IN A POPULATION AT HIGH-RISKFOR STOMACH-CANCER IN VENEZUELA

Determinants of plasma pepsinogens (PG) levels were studied in 1365 pa rticipants in a chemoprevention trial for gastric pre-cancerous lesion s being conducted in Venezuela. Gastric biopsies, plasma samples and i nformation on smoking and dietary habits were obtained at baseline exa mination. Both PG-I and PG-ll levels increased progressively with the level of Helicobacter pylori infection in gastric biopsies, resulting in no clear trend in the I/II ratio. Instead, there was a progressive decrease in the I/II ratio with increasing degrees of infiltration of polynuclear cells and monocytes, atrophy, intestinal metaplasia and th e stage of pre-cancerous lesions. The mean I/II ratios for atrophic ga stritis or more advanced lesions were less than 4.0. When subjects wit h the I/II ratio 4 or higher were used as controls, severe reduction i n the I/II ratio (< 2.0) was inversely associated with tobacco consump tion. This may be due to a pharmacological effect of nicotine. The sev ere reduction of I/II ratio was also inversely associated with fresh f ruit consumption. In addition, a decreased I/II ratio was positively a ssociated with rice/pasta and arepas (tortilla made from corn) consump tion and inversely associated with plantain consumption. possible effe cts of vitamins and starchy food on the development of atrophic gastri tis need to be studied further. (C) 1995 Wiley-Liss, Inc.