Clinical use of proton-pump inhibitors but not H2-blockers or antacid/alginates raises the serum levels of amidated gastrin-17, pepsinogen I and pepsinogen II in a random adult population

• Published in: Scandinavian journal of gastroenterology Vol. 44; no. 5; p. 564
• Main Authors: Agréus, Lars, Storskrubb, Tom, Aro, Pertti, Ronkainen, Jukka, Talley, Nicholas J, Sipponen, Pentti
• Format: Journal Article
• Language: English
• Published: England 01.01.2009
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - blood; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Gastric Acid - secretion; Gastric Mucosa - drug effects; Gastric Mucosa - pathology; Gastrins - blood; Gastrins - secretion; Histamine H2 Antagonists - adverse effects; Histamine H2 Antagonists - therapeutic use; Humans; Male; Middle Aged; Pepsinogen A - blood; Pepsinogen C - blood; Pepsinogens - blood; Pepsinogens - secretion; Probability; Proton Pump Inhibitors - adverse effects; Proton Pump Inhibitors - therapeutic use; Risk Assessment; Statistics, Nonparametric; Surveys and Questionnaires; Young Adult
• ISSN: 1502-7708
• DOI: 10.1080/00365520902745062

Proton-pump inhibitors (PPIs), H(2) receptor antagonists (H(2)RAs) and antacids/alginates reduce intragastric acidity and may thus influence normal gastric physiology. The purpose of this study was to examine the effect of these compounds on serum levels of amidated gastrin-17 (G-17) and pepsinogens (PGI & PGII) in a large, random, adult Swedish population sample with uninfected stomach mucosa. The initial sample subjects (n=1000, mean age 50 years, range 20-80 years) completed a questionnaire on the use of acid inhibitory drugs 1 week and/or 3 months before study entry. All subjects (n=590) with normal gastric mucosa as delineated by serum biomarkers were included. Among them, serum levels of PGI, PGII and G-17 were compared between those who used acid inhibitory drugs and those who did not. The serum levels of G-17 or pepsinogens in the subjects who reported use of H(2)RAs (n=18) or antacid/alginates (n=66) during the previous 3 months did not differ from those in non-users (n=471). However, the median levels of G-17 and pepsinogens were significantly (p<0.001) higher among the PPI users (n=35) than among non-users: the levels were approximately doubled. The ratio of PGI/PGII was, however, similar between PPI users and non-users, or those using antacids/alginates or H(2)RAs. Among subjects using PPIs, the serum levels of pepsinogens correlated positively (p<0.01) with the serum levels of G-17. PPIs but not antacids/alginates or H(2)RAs markedly increase the fasting levels of serum amidated G-17 and pepsinogens among ordinary patients in everyday clinical practice.