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Fundic Atrophic Gastritis in an Elderly Population: Effect on Hemoglobin and Several Serum Nutritional Indicators
Author(s) -
Krasinski Stephen D.,
Russell Robert M.,
Samloff I. Michael,
Jacob Robert A.,
Dallal Gerard E.,
McGandy Robert B.,
Hartz Stuart C.
Publication year - 1986
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1986.tb03985.x
Subject(s) - atrophic gastritis , medicine , gastroenterology , gastritis , pepsin , vitamin b12 , atrophy , population , pernicious anemia , anemia , endocrinology , stomach , biology , biochemistry , environmental health , enzyme
The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free‐living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen ***I/pepsinogen II ratio less than 2.9, indicating atrophic gastritis, was found in 113 (31.5%) subjects. The prevalence of atrophic gastritis increased significantly with advancing age ( P <.05). Within the atrophic gastritis group, 84 had a pepsinogen I level greater than or equal to 20 μg/L, indicating mild to moderate atrophic gastritis, and 29 had a pepsinogen I level less than 20 μg/L, indicating severe atrophic gastritis or gastric atrophy. A significant increase in the prevalences of elevated serum gastrin levels ( P <.005), low serum vitamin B 12 levels ( P <.005), circulating intrinsic factor antibody ( P <.005), and anemia ( P <.025) was observed with stepwise increases in severity of atrophic gastritis. Subjects with atrophic gastritis exhibited a lower mean serum vitamin B 12 level ( P <.05) and a higher mean folate level ( P <.05), but no difference was detected in mean hemoglobin levels or serum levels of iron, ferritin, retinal or α‐tocopherol. It is concluded that serum pepsinogen I and pepsinogen II levels can be used to determine the prevalence and severity of atrophic gastritis, that atrophic gastritis is common in an elderly population, and that atrophic gastritis is associated with vitamin B 12 deficiency and anemia. Further, higher folate levels in atrophic gastritis may be related to an accumulation of 5‐methyl tetrahydrofolate in serum due to vitamin B 12 deficiency and/or greater folate synthesis by the intestinal flora resulting from bacterial overgrowth secondary to hypo‐ or achlorhydria.