The effect of 5-year vitamin C supplementation on serum pepsinogen level and Helicobacter pylori infection

Cancer Sci. 2003 Apr;94(4):378-82. doi: 10.1111/j.1349-7006.2003.tb01450.x.


We conducted a population-based, double-blind, randomized controlled trial to examine the effect of vitamin C supplementation on serum pepsinogen (PG) level, Helicobacter pylori (H. pylori ) infection, and cytotoxin-associated gene A (Cag A) status. Subjects aged 40 to 69 years living in one village in Akita prefecture, a high-risk area for gastric cancer in Japan, were recruited through annual health check-up programs. Among 635 subjects diagnosed as having chronic gastritis on the basis of serum PG levels, after excluding ineligible cases, 439 subjects were assigned to one of four groups using a 2 x 2 factorial design (0 or 15 mg/day beta-carotene and 50 or 500 mg/day vitamin C). However, based on the results from two beta-carotene trials in the United States, we discontinued beta-carotene (vitamin C supplementation was continued). Finally, 120 subjects in the low-dose group (vitamin C 50 mg), and 124 subjects in the high-dose group (vitamin C 500 mg) completed the 5-year supplementation. The difference in the change of PGI/II ratio between baseline and after 5-year follow up was statistically significant between the intervention groups among those who completed the supplementation: - 0.25 for the low-dose group and - 0.13 for the high-dose group (P = 0.046). To conclude, vitamin C supplementation may protect against progression of gastric mucosal atrophy.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Antigens, Bacterial / blood
  • Ascorbic Acid / administration & dosage*
  • Ascorbic Acid / blood
  • Bacterial Proteins / blood
  • Chronic Disease
  • Dietary Supplements
  • Double-Blind Method
  • Female
  • Gastritis, Atrophic / blood*
  • Gastritis, Atrophic / microbiology
  • Helicobacter Infections / blood*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Pepsinogen A / blood*
  • Pepsinogen C / blood*
  • Time Factors


  • Antigens, Bacterial
  • Bacterial Proteins
  • cagA protein, Helicobacter pylori
  • Pepsinogen C
  • Pepsinogen A
  • Ascorbic Acid