Low PGⅡ levels may indicate an increased risk of gastric mucosal intestinal metaplasia in outpatients experiencing stomach discomfort: a retrospective cross-sectional study

Abstract Background and aims Limited research has been conducted on the correlation between pepsinogen (PG)Ⅱ and gastric mucosal intestinal metaplasia (GIM) among individuals seeking medical attention for stomach-related issues. The objective of this retrospective cross-sectional analysis was to identify key factors associated with GIM development and explore the connection between PGⅡ levels and GIM among outpatients experiencing stomach discomfort. Methods Participants with stomach discomfort, who were not utilizing any medication to suppress stomach acid, were enrolled in the study. Logistic regression analysis was employed to investigate the association between 14 potential factors, encompassing lifestyle choices, and the occurrence of GIM within this research. Results In multivariate analysis, males (odds ratio [OR], 1.568; p = 0.013), low PGⅡ levels (OR, 0.975; p = 0.025) and the eradication history of Helicobacter pylori (Hp) (OR, 1.549; p = 0.020) were identified as risk factors for the prevalence of GIM. After adjusting for PGⅡ levels, there was a significant difference in the prevalence of GIM between males with high and low PGⅡ compared to females with high PGⅡ levels (OR 2.075 and 1.336; p = 0.005 and 0.001). There was also a significant difference in the prevalence of GIM between females with low and high PGⅡ levels (OR 1.349; p = 0.021). Among individuals with higher PGII levels, the prevalence of GIM was significantly different between females without an Hp eradiation history and males with or without eradication history (OR, 1.408 and 1.368; p = 0.016 and 0.043, respectively ). Among individuals with lower PGⅡ levels, the prevalence of GIM was significantly different between females without an Hp eradication history, females with eradication history, and males with eradication history(OR, 1.545 and 1.463; p = 0.030 and 0.005 ) . Conclusion Males, those with low PGⅡ levels, and individuals with a history of Hp eradication could be significant predictors for GIM in outpatients experiencing stomach discomfort. Low PGⅡ levels may indicate an increased risk of GIM in outpatients experiencing stomach discomfort.