Relationship of the PGⅠ/PGⅡ ratio and serum Gastrin-17 level with Helicobacter pylori infection and disease severity in elderly patients with chronic atrophic gastritis

Duan Yuanjun; Xin Haixia; Guo Yue; Zhang Xiao; Guo Meie; Wang Jianfeng; Liu Juanjuan; Wei Mingchao

doi:10.11986/j.issn.1673-873X.2025.06.10

Abstract：Objective To investigate the relationships of the pepsinogen Ⅰ/pepsinogen Ⅱ(PGⅠ/PGⅡ)ratio and serum gas-trin-17(G-17)level with Helicobacter pylori(Hp)infection and disease severity in elderly patients with chronic atrophic gastritis(CAG),aiming to provide clinical guidance for prevention and control of Hp infection.Methods From January 2022 to January 2024,148 elderly CAG patients admitted to the 960th Hospital were enrolled and classified by disease sever-ity into mild(n=42),moderate(n=57)and severe(n=49)groups.Patients were also grouped by Hp infection status in-to an Hp-infected group(n=108)and an uninfected group(n=40).Spearman rank correlation analysis was used to exam-ine relationships between PGⅠ/PGⅡ ratio,serum G-17 level and disease severity.Receiver operating characteristic(ROC)curves were used to assess the predictive value of PGⅠ/PGⅡ,serum G-17 and their combined detection for Hp infection.Logistic regression analysis was used to identify factors associated with Hp infection in elderly CAG patients.Results As disease severity increased,both the PGⅠ/PGⅡ ratio and serum G-17 level showed a decreasing trend,with statistically sig-nificant inter-group differences(P＜0.05).Spearman rank correlation analysis indicated that the PGⅠ/PGⅡ ratio and ser-um G-17 level were negatively correlated with disease severity(rs=—0.753 and-0.698,respectively;both P＜0.05).The Hp-infected group had significantly lower PGⅠ/PGⅡ ratio and lower serum G-17 level than the uninfected group(both P＜0.05).The areas under the ROC curve(AUC)for predicting Hp infection were 0.837(95％CI:0.792-0.887)for PGⅠ/PGⅡ,0.742(95％CI:0.697-0.787)for serum G-17,and 0.914(95％CI:0.869-0.959)for the combined test;the combined prediction outperformed PGⅠ/PGⅡ alone and G-17 alone(Z=11.924 and 9.877,respectively;both P＜0.001).The Hp-infected group had significantly higher proportions of elevated body mass index(BMI),smoking history,drinking history,and family history of Hp infection compared with the uninfected group(all P＜0.05).Multivariate analy-sis demonstrated that BMI(OR=1.711,95％CI:1.094-2.675),drinking history(OR=2.092,95％CI:1.171-3.737),family history of Hp infection(OR=2.018,95％CI:1.251-3.255),PGⅠ/PGⅡ ratio(OR=3.522,95％CI:1.896-6.543)and serum G-17 level(OR=3.323,95％CI:1.747-6.321)were correlated with Hp infection in elderly CAG patients(all P＜0.05).Conclusion In elderly patients with CAG,the PGⅠ/PGⅡ ratio and serum G-17 level are closely correlated with Hp infection and disease severity.These indicators may be considered for routine monitoring in elder-ly CAG patients for preliminary Hp screening and assessment of disease severity.