Effects of Proton Pump Inhibitor Therapy, <i>H</i>. <i>pylori</i> Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations

Veysey-Smith, Reuben, Moore, Andrew R, Murugesan, Senthil V, Tiszlavicz, Laszlo, Dockray, Graham J, Varro, Andrea and Pritchard, D Mark ORCID: 0000-0001-7971-3561
(2021) Effects of Proton Pump Inhibitor Therapy, <i>H</i>. <i>pylori</i> Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations. FRONTIERS IN ENDOCRINOLOGY, 12. 741887-.

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<h4>Background</h4>Hypergastrinaemia occasionally indicates the presence of a gastrinoma. However it is much more commonly associated with various benign causes including proton pump inhibitor (PPI) use, <i>Helicobacter pylori</i> infection and/or atrophic gastritis. The extent to which these factors interact to influence fasting serum gastrin concentrations remains incompletely understood.<h4>Materials and methods</h4>Fasting serum gastrin concentrations were measured by radioimmunoassay in 1,400 patients attending for diagnostic oesophagogastro-duodenoscopy. After exclusions, 982 patients were divided into four groups and their results analysed. We compared gastrin concentrations in normal patients (no <i>H. pylori</i> infection, no PPI use and no histological evidence of gastric preneoplasia (n=233)), with those in patients who were taking regular PPIs (<i>H. pylori</i> negative with no gastric preneoplasia (n=301)), patients who had active <i>H. pylori</i> infection but no gastric preneoplasia (n=164) and patients with histologically confirmed gastric preneoplasia (n=284).<h4>Results</h4>Median fasting gastrin concentration in the normal group was 20pM and was significantly increased in PPI users (46pM, p<0.0001), patients with active <i>H. pylori</i> infection (27pM, p<0.0001), and patients with antral (25pM, p<0.01) or corpus (48pM, p<0.0001) gastric preneoplasia. PPI use resulted in further significant increases in fasting serum gastrin concentrations in patients who were infected with <i>H. pylori</i> (50pM, n=56) or who had antral gastric preneoplasia (53pM, n=87), but did not significantly alter serum gastrin concentrations in patients with corpus preneoplasia (90pM, n=66).<h4>Conclusions</h4>PPI use, <i>H. pylori</i> infection and atrophic gastritis all caused significant elevations of median fasting gastrin concentrations. However, several patients who had potential risk factors for hypergastrinaemia still demonstrated fasting serum gastrin concentrations within the normal range.

Item Type: Article
Uncontrolled Keywords: gastrin, proton pump inhibitor, Helicobacter pylori, atrophic gastritis, oesophagogastroduodenoscopy
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 03 Dec 2021 11:54
Last Modified: 18 Oct 2023 09:32
DOI: 10.3389/fendo.2021.741887
Open Access URL: https://doi.org/10.3389/fendo.2021.741887
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3144506