Differential Impacts of Helicobacter pylori Antibody Typing on Gastric Secretory Function: A Cross-Sectional Study Based on Serum Biomarkers

Objective: Gastric secretory dysfunction is prevalent in Helicobacter pylori (Hp)-infected gastropathies, but the specific mechanisms by which different Hp antibody subtypes mediate these functional alterations remain incompletely elucidated. This cross-sectional clinical observational study aimed to systematically explore the associations between specific Hp antibody subtype infection status and multiple gastric function parameters, thereby clarifying potential differences in their impacts on gastric secretory function. Methods: Serum pepsinogen I (PGI), pepsinogen II (PGII), PGI/PGII ratio (PGR), gastrin-17 (G-17), and Hp antibody subtypes were analyzed in 2618 patients. Baseline data and serum test results were evaluated using cross-sectional analysis. Results: The Hp antibody-negative group showed significantly higher serum PGI (177.96±59.74 vs 183.81±63.80, P=0.020) and PGR (11.83±4.91 vs 14.19±5.32, P<0.001), but lower PGII levels (P<0.001), compared with the positive group. Both Hp (I) and Hp (II) groups exhibited higher PGII levels than the negative group (P<0.001). PGR showed a hierarchical trend: Hp (I) group (11.35±4.63) < Hp (II) group (12.66±5.25) < negative group (14.19±5.32, P<0.001). G-17 levels were higher in infected groups than in the negative group (P<0.001). Males in infected groups had higher PGI levels, while males in the negative group showed significantly higher PGII, PGI, and G-17 levels (P<0.05). Patients ≤60 years old had lower PGI/PGII and higher PGR across all groups (P<0.05). Correlation analysis showed G-17 was positively associated with PGII and negatively with PGR (P<0.05). Conclusions: Hp infection affects gastric function serum markers: Hp(-) individuals have higher PGI/PGR and lower PGII than Hp(+). PGII and G-17 increase progressively in Hp(-), Hp(II), and Hp(I) groups. Males and individuals >60 years show elevated PGI/PGII. G-17 correlates positively with PGII and negatively with PGR, and positively with age in Hp(-) individuals.