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

BackgroundHypergastrinaemia occasionally indicates the presence of a gastrinoma. However it is much more commonly associated with various benign causes including proton pump inhibitor (PPI) use, Helicobacter pylori infection and/or atrophic gastritis. The extent to which these factors interact to in...

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Autores principales:	Reuben Veysey-Smith, Andrew R. Moore, Senthil V. Murugesan, Laszlo Tiszlavicz, Graham J. Dockray, Andrea Varro, D. Mark Pritchard
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	gastrin proton pump inhibitor Helicobacter pylori atrophic gastritis oesophagogastroduodenoscopy Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/0efdf513cd5b4eba921d632e19d174bc
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spelling	oai:doaj.org-article:0efdf513cd5b4eba921d632e19d174bc2021-11-18T08:52:28ZEffects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations1664-239210.3389/fendo.2021.741887https://doaj.org/article/0efdf513cd5b4eba921d632e19d174bc2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.741887/fullhttps://doaj.org/toc/1664-2392BackgroundHypergastrinaemia occasionally indicates the presence of a gastrinoma. However it is much more commonly associated with various benign causes including proton pump inhibitor (PPI) use, Helicobacter pylori infection and/or atrophic gastritis. The extent to which these factors interact to influence fasting serum gastrin concentrations remains incompletely understood.Materials and MethodsFasting 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 H. pylori infection, no PPI use and no histological evidence of gastric preneoplasia (n=233)), with those in patients who were taking regular PPIs (H. pylori negative with no gastric preneoplasia (n=301)), patients who had active H. pylori infection but no gastric preneoplasia (n=164) and patients with histologically confirmed gastric preneoplasia (n=284).ResultsMedian fasting gastrin concentration in the normal group was 20pM and was significantly increased in PPI users (46pM, p<0.0001), patients with active H. pylori 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 H. pylori (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).ConclusionsPPI use, H. pylori 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.Reuben Veysey-SmithAndrew R. MooreAndrew R. MooreSenthil V. MurugesanSenthil V. MurugesanLaszlo TiszlaviczGraham J. DockrayAndrea VarroD. Mark PritchardD. Mark PritchardFrontiers Media S.A.articlegastrinproton pump inhibitorHelicobacter pyloriatrophic gastritisoesophagogastroduodenoscopyDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gastrin proton pump inhibitor Helicobacter pylori atrophic gastritis oesophagogastroduodenoscopy Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	gastrin proton pump inhibitor Helicobacter pylori atrophic gastritis oesophagogastroduodenoscopy Diseases of the endocrine glands. Clinical endocrinology RC648-665 Reuben Veysey-Smith Andrew R. Moore Andrew R. Moore Senthil V. Murugesan Senthil V. Murugesan Laszlo Tiszlavicz Graham J. Dockray Andrea Varro D. Mark Pritchard D. Mark Pritchard Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
description	BackgroundHypergastrinaemia occasionally indicates the presence of a gastrinoma. However it is much more commonly associated with various benign causes including proton pump inhibitor (PPI) use, Helicobacter pylori infection and/or atrophic gastritis. The extent to which these factors interact to influence fasting serum gastrin concentrations remains incompletely understood.Materials and MethodsFasting 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 H. pylori infection, no PPI use and no histological evidence of gastric preneoplasia (n=233)), with those in patients who were taking regular PPIs (H. pylori negative with no gastric preneoplasia (n=301)), patients who had active H. pylori infection but no gastric preneoplasia (n=164) and patients with histologically confirmed gastric preneoplasia (n=284).ResultsMedian fasting gastrin concentration in the normal group was 20pM and was significantly increased in PPI users (46pM, p<0.0001), patients with active H. pylori 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 H. pylori (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).ConclusionsPPI use, H. pylori 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.
format	article
author	Reuben Veysey-Smith Andrew R. Moore Andrew R. Moore Senthil V. Murugesan Senthil V. Murugesan Laszlo Tiszlavicz Graham J. Dockray Andrea Varro D. Mark Pritchard D. Mark Pritchard
author_facet	Reuben Veysey-Smith Andrew R. Moore Andrew R. Moore Senthil V. Murugesan Senthil V. Murugesan Laszlo Tiszlavicz Graham J. Dockray Andrea Varro D. Mark Pritchard D. Mark Pritchard
author_sort	Reuben Veysey-Smith
title	Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
title_short	Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
title_full	Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
title_fullStr	Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
title_full_unstemmed	Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations
title_sort	effects of proton pump inhibitor therapy, h. pylori infection and gastric preneoplastic pathology on fasting serum gastrin concentrations
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0efdf513cd5b4eba921d632e19d174bc
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Effects of Proton Pump Inhibitor Therapy, H. pylori Infection and Gastric Preneoplastic Pathology on Fasting Serum Gastrin Concentrations

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