The Study Of Reference Intervals And Preliminary Clinical Application Of Serum Pepsinogen Using Latex Enhanced Immune Turbidimetric Assay For Adult Population In Hunan Changsha Region

Objective To investigate the influences of some physiological index and H. pylori on the distributions of serum pepsinogen (sPG) levels;To establish the reference intervals of sPG using latex enhanced immunoturbidimetric assay for adult population;To study the clinical meanings of sPG and H. pylori test in diagnosising the atrophic gastritis.Methods1. The information of the population who received a health-screening in the Second Xiangya hospital from2012April to2013July were collected, and used to determine the relationships between sPG levels and H. pylori infection, age, sex, and BMI respectively.2. We stratified the populations, who enrolled according to the exclusion criterion, by H. pylori status, gender and age, and the reference intervals were obtained by statistical analysis under the instruction of the C28-A3document.3. Serum pepsinogen and H. pylori were measured in both healthy group and atrophy gastritis group. The cut-off value for atrophic gastritis was determined by applying the ROC analysis. Results1. The mean PGⅠ and PGⅡ levels were higher in H. pylori negative male individuals than in H. pylori negative female individuals (P<0.001), but the differences of PGⅠ/PGⅡ between H. pylori negative males and females were not significant (P>0.05). Respect to the same gender, the mean PGI and PGⅡ levels were lower in H. pylori negative individuals than in H. pylori positive individuals (P<0.001), while the PGⅠ/PGⅡ levels were higher (P<0.001). The mean PGI, PGII and PGⅠ/PGⅡ levels between different genders in H. pylori positive group were similar (P>0.05). With regardless of the H. pylori status and sex, the PGⅠ and PGⅡ levels increase with the age (P<0.001), but PGⅠ/PGⅡ levels keep consistent (P>0.05). Results from the logistic regression gave a statistical significance (P=0.000) and showed that the H. pylori positive status was the only risk factor to the decreased PGⅠ/PGⅡ levels compared with sex, age and BMI.2. Reference intervals for sPG in a gender and age appropriate adult population using latex enhanced immunoturbidimetric assay are reported.3. The PGⅠ/PGⅡ and PGⅠ levels were significantly lower in atrophy gastritis than healthy individuals (P<0.01). The PGⅠ/PGⅡ cut-off value for atrophic gastritis was2.7for H. pylori negative and2.3for H. pylori positive individuals. While the PGI cut-off value for atrophic gastritis was37.3ng/ml for H. pylori negative and42.3ng/ml for H. pylori positive individuals respectively. Conclusions The gender, age and H. pylori infection status were important factors which can affect the sPG levels. We firstly reported the reference intervals of sPG for healthy adult population in Changsha city according to the gender and age. The optimal cut-off values for diagnosising the atrophic gastritis using sPG were also established. To increase the efficacy of the PGI/II and PGI for the detection of atrophic gastritis, the cut-off value of the PGI/II and PGI should be stratified according to the H. pylori infection status. Our study provided useful references to laboratory and clinican.