gms | German Medical Science

Introduction / Background: Epidemiologic data on chronic atrophic gastritis (CAG) from general population samples are sparse [Ref. 1]. The aim of this study was to assess prevalence of CAG according to potential risk factors and clinical outcomes in a large-scale population based study.

Material and Methods: In the baseline examination of ESTHER [Ref. 2], a population-based cohort study conducted in Saarland/Germany, serological measurements of pepsinogen (PG) I and II and Helicobacter pylori antibodies were taken in 9,444 women and men aged 50 to 74 years. Information on potential risk factors and medical history were obtained by questionnaire.

Results: With the definition previously used in the EUROGAST study [Ref. 3] (PG I < 25 ng/ml), prevalence of CAG increased from 4.8% in age group 50-54 years to 8.7% in age group 70-74 years, but was unrelated to sex and other putative risk factors of CAG. An alternative definition of CAG (PG I < 70 ng/ml & PG I / PG II < 3), used in multiple studies from Japan (1), revealed a stronger increase with age (from 2.7% to 9.1%) and a strong association with H. pylori infection (adjusted odds ratio: 2.9, 95% confidence interval: 2.4 to 3.7). With both definitions, a strong inverse association with the frequency of heartburn was seen.

Discussion / Conclusions: CAG is a common condition among older adults in Germany. A strong increase with age, but no gender difference was seen in CAG prevalence, which was inversely associated with frequency of heartburn. A strong association with H. pylori infection was seen with a definition of CAG based on both PG I and the PG I / PG II ratio.