Extragastral clinical manifestations in patients with chronic atrophic gastritis

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Abstract

B12 and iron deficiency anemia, vitamin B12 deficiency and latent iron deficiency belong to the most well-known extragastric manifestations of chronic atrophic gastritis (CAG).

The aim: to assess the incidence of extragastric clinical manifestations (vitamin B12 deficiency, iron deficiency, hypoproteinemia) in patients with CAG.

Material and methods. 143 patients aged from 20 to 79 years (residents of Saint Petersburg and the Leningrad region) were examined. The average age of participants was 59 (49–66) years. All patients underwent serum determination of pepsinogen-I (P-I), pepsinogen-II (P-II), gastrin-17 and H. pylori antibodies, also esophagogastroduodenoscopy with biopsy according to the OLGA system. Confirmation of H. pylori infection was performed by assessing the presence of antigen in stool by means of immunochromatography use. Indexes of clinical and biochemical blood analysis of patients (iron levels, ferritin, vitamin B12, holotranscobalamin, total protein level) were estimated.

Results. Anemia was found in 29.6%, latent iron deficiency in 7.7%, vitamin B12 deficiency in 9.8%, and hypoproteinemia in 2.1% of patients. A weak correlation was fixed between the following indexes: P-I and iron level (ρ = 0.220, p = 0.01), P-I and B12 level (ρ = 0.250, p = 0.003), P-I/P-II index and iron level (ρ = 0.229, p = 0.007), P-I/P-II and B12 level (ρ = 0.176, p = 0.042). Ferritin level was statistically significantly higher in patients with H. pylori infection (p < 0.001). There was no correlation between anemia and stages of atrophy (p = 0.625).

Conclusion. In CAG patients with different stages of atrophy, no statistically significant differences concerning the presence of B12 deficiency and iron deficiency conditions were found. Positive correlation was revealed between P-I, P-I/P-II and deficiency of iron and vitamin B12. Presence of vitamin B12 or iron deficiency is independent of the etiology of CAG.

About the authors

Igor G. Bakulin

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: igbakulin@yandex.ru
ORCID iD: 0000-0002-6151-2021

MD, Dr. Sci. (Medicine), professor, head of the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

Anastasia G. Sushilova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: Anastasiya.s1311@gmail.com
ORCID iD: 0000-0002-7277-5046

MD, postgraduate student of the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

Alexander V. Zharkov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: igbakulin@yandex.ru

MD, PhD (Medicine), chairman of the Healthcare Committee of the Leningrad region, assistant at the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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2. Fig. 1. Distribution of iron and vitamin B12 deficiencies in chronic atrophic gastritis in patients included in the study

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3. Fig. 2. Distribution of deficiencies depending on the etiology of chronic atrophic gastritis in patients included in the study

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4. Fig. 3. Analysis of ferritin levels depending on H. pylori status (by determination of H. pylori antigen in feces) in patients included in the study

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