Long-term effect of Helicobacter pylori infection on serum pepsinogens

Serum pepsinogen values are markers of gastric mucosal status and of gastri c cancer risk. The effect of Helicobacter pylori infection and sibship size on change of serum pepsinogen values over a seven-year span was investigat ed. Data from 2584 subjects with phlebotomy were analyzed both in 1989 and in 1996. The subjects were classified by H. pylori serology and sibship siz e (1-3 vs. 4 and more). Pepsinogen I (PG I) to II (PG II) ratio in '96 minu s that in '89 was defined as Delta PG I/II and compared among the groups, D elta PG I/II was lower and decrease of PG I/II was more frequent among H. p ylori-positive subjects than among negative subjects. The difference was ow ing to a decrease of PG I in all subjects and owing to an increase of PG II in those not younger than 30 years in '89, In H, pylori-positive subjects, those with a larger sibship size showed lower Delta PG I/II and higher fre quency of PG I/II decline. H. pylori infection exerts a reducing effect on PG I/II during the seven-year span. The effect of H. pylori is stronger amo ng those with a larger sibship size, who are expected to have been infected with H, pylori in childhood. Inducing atrophy of gastric mucosa, which is reflected by a decline of PG I/II, may be one of the mechanisms through whi ch H. pylori elevates the risk of gastric cancer.