TY - JOUR
T1 - Gastric mucosal status in populations with a low prevalence of Helicobacter pylori in Indonesia
AU - Miftahussurur, Muhammad
AU - Nusi, Iswan Abbas
AU - Akil, Fardah
AU - Syam, Ari Fahrial
AU - Wibawa, I. Dewa Nyoman
AU - Rezkitha, Yudith Annisa Ayu
AU - Maimunah, Ummi
AU - Subsomwong, Phawinee
AU - Parewangi, Muhammad Luthfi
AU - Mariadi, I. Ketut
AU - Adi, Pangestu
AU - Uchida, Tomohisa
AU - Purbayu, Herry
AU - Sugihartono, Titong
AU - Waskito, Langgeng Agung
AU - Hidayati, Hanik Badriyah
AU - Lusida, Maria Inge
AU - Yamaoka, Yoshio
N1 - Publisher Copyright:
© 2017 Miftahussurur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/5
Y1 - 2017/5
N2 - In Indonesia, endoscopy services are limited and studies about gastric mucosal status by using pepsinogens (PGs) are rare. We measured PG levels, and calculated the best cutoff and predictive values for discriminating gastric mucosal status among ethnic groups in Indonesia. We collected gastric biopsy specimens and sera from 233 patients with dyspepsia living in three Indonesian islands. When ≥5.5 U/mL was used as the best cutoff value of Helicobacter pylori antibody titer, 8.6% (20 of 233) were positive for H. pylori infection. PG I and II levels were higher among smokers, and PG I was higher in alcohol drinkers than in their counterparts. PG II level was significantly higher, whereas PG I/II ratios were lower in H. pylori-positive than in H. pylori-negative patients. PG I/II ratios showed a significant inverse correlation with the inflammation and atrophy scores of the antrum. The best cutoff values of PG I/II were 4.05 and 3.55 for discriminating chronic and atrophic gastritis, respectively. PG I, PG II, and PG I/II ratios were significantly lower in subjects from Bangli than in those from Makassar and Surabaya, and concordant with the ABC group distribution; however, group D (H. pylori negative/PG positive) was the lowest in subjects from Bangli. In conclusion, validation of indirect methods is necessary before their application. We confirmed that serum PG level is a useful biomarker determining chronic gastritis, but a modest sensitivity for atrophic gastritis in Indonesia. The ABC method should be used with caution in areas with a low prevalence of H. pylori.
AB - In Indonesia, endoscopy services are limited and studies about gastric mucosal status by using pepsinogens (PGs) are rare. We measured PG levels, and calculated the best cutoff and predictive values for discriminating gastric mucosal status among ethnic groups in Indonesia. We collected gastric biopsy specimens and sera from 233 patients with dyspepsia living in three Indonesian islands. When ≥5.5 U/mL was used as the best cutoff value of Helicobacter pylori antibody titer, 8.6% (20 of 233) were positive for H. pylori infection. PG I and II levels were higher among smokers, and PG I was higher in alcohol drinkers than in their counterparts. PG II level was significantly higher, whereas PG I/II ratios were lower in H. pylori-positive than in H. pylori-negative patients. PG I/II ratios showed a significant inverse correlation with the inflammation and atrophy scores of the antrum. The best cutoff values of PG I/II were 4.05 and 3.55 for discriminating chronic and atrophic gastritis, respectively. PG I, PG II, and PG I/II ratios were significantly lower in subjects from Bangli than in those from Makassar and Surabaya, and concordant with the ABC group distribution; however, group D (H. pylori negative/PG positive) was the lowest in subjects from Bangli. In conclusion, validation of indirect methods is necessary before their application. We confirmed that serum PG level is a useful biomarker determining chronic gastritis, but a modest sensitivity for atrophic gastritis in Indonesia. The ABC method should be used with caution in areas with a low prevalence of H. pylori.
UR - http://www.scopus.com/inward/record.url?scp=85018943870&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0176203
DO - 10.1371/journal.pone.0176203
M3 - Article
C2 - 28463979
AN - SCOPUS:85018943870
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 5
M1 - e0176203
ER -