Serum Gastrin Levels in Relation to Helicobacter pylori Infection and Various Upper Gastrointestinal Diseases

ABSTRACT

PURPOSE: Gastrin secreted from antral G cell is a major hormone in regulation of gastric acid secretion. In adults, there are many reports that gastrin is correlated with H. pylori infection and peptic ulcer diseases, but those reports are rare in pediatric field. This study was done to research the serum gastrin levels in relation to H. pylori infection and various upper gastrointestinal diseases. METHODS: Upper gastrointestinal endoscopy was performed on 166 patients who visited OPD or were admitted to the Department of Pediatrics, Yonsei University College of Medicine between Aug. 1992 and Jul. 1994 due to recurrent abdominal pain and upper gastrointestinal bleeding. Detection of H. pylori infection was done by CLO test (rapidurease test) and Warthin-Starry silver stain using biopsied specimens, and the ELISA (Enzyme-linked Immunosorbent assay) test was done with their serum at the same time. Patients with any positive results were regarded as positive for H. pylori infection. Serum fasting gastrin levels were measured by I125 tagged radioimmunoassay. Statistical analysis was mode by the Student t test, mann-Whitney rank-sum and ANOVA multiple comparison test by BMDP, and the difference were taken as significant when p value below 0.05 RESULTS: 1) The mean serum gastrin level was significantly higher in H. pylori positive children (40.1+/-13.7pg/mL) than in negative children (29.5+/-7.5pg/mL). p value below 0.00005. 2) The mean serum gastrin level was 42.5+/-16.3pg/mL in duodenal ulcer patients, 36.9+/-17.9pg/mL in gastric ulcer, 34.4+/-9.9pg/mL in chronic superficial nodular gastritis, 30.2 +/-8.0pg/mL in superficial gastritis, 29.8+/-8.4pg/mL in normal group, and 30.7+/-4.2pg/mL in patients with other upper gastrointestinal diseases. The mean serum gastrin level of duodenal ulcer group was significantly higher than of normal or superficial gastritis group (p<0.01), but showed no significant difference with that of gastric ulcer or chronic superficial nodular gastritis group. 3) The serum gastrin level of H. pylori positive duodenal ulcer patients was significantly higher than those of H. pylori negative patients with other remaining gastrointestinal diseases including H. pylori negative duodenal ulcer group (p<0.05), and the serum gastrin level was significantly higher in H. pylori positive gastric ulcer patients than in H. pylori negative patients with other remaining gastrointestinal diseases including H. pylori negative gastric ulcer patients (p<0.05). In normal and superficial gastritis group, the serum gastrin level of H. pylori positive children was significantly higher than that of H. pylori negative children (p<0.05). There was no significant difference in the serum gastrin levels between chronic superficial nodular gastritis positive and negative group. CONCLUSIONS: The serum gastrin levels were significantly increased in H. pylori positive children, especially in H. pylori positive duodenal and gastric ulcer patients. It is assumed that H. pylori has a major role in the pathogenesis of peptic ulcer diseases inducing increase in gastrin release from antral G cells.