Epidemiology of chronic atrophic gastritis: population-based study among 9444 older adults from Germany

Aliment Pharmacol Ther. 2007 Sep 15;26(6):879-87. doi: 10.1111/j.1365-2036.2007.03430.x.


Background: Epidemiological data on chronic atrophic gastritis from general population samples are sparse in Germany.

Aim: To assess prevalence of chronic atrophic gastritis according to potential risk factors and clinical outcomes in a large-scale population-based study.

Methods: In the baseline examination of ESTHER, a population-based cohort study conducted in Germany, serological measurements of pepsinogen (PG) I and II and Helicobacter pylori antibodies were taken in 9444 women and men aged 50-74 years. Information on potential risk factors and medical history were obtained by questionnaire.

Results: With the definition used in the EUROGAST study (PG I < 25 ng/mL), prevalence of chronic atrophic gastritis increased from 4.8% in age group 50-54 to 8.7% in age group 70-74. An alternative definition of chronic atrophic gastritis (PG I < 70 ng/mL and PG I/PG II < 3), used in multiple studies from Japan, revealed a greater increase with age (from 2.7% to 9.1%) and a strong association with H. pylori infection (adjusted odds ratio: 2.9, 95% confidence interval: 2.4-3.7). With both definitions, a strong inverse association with heartburn was observed.

Conclusions: Overall chronic atrophic gastritis prevalence is low among older adults in Germany, but it strongly increases with age and H. pylori infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Female
  • Gastritis, Atrophic / epidemiology*
  • Germany / epidemiology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / immunology
  • Helicobacter pylori / immunology*
  • Humans
  • Male
  • Middle Aged
  • Pepsinogen A / analysis
  • Pepsinogen A / urine
  • Pepsinogen C / metabolism*
  • Prevalence
  • Surveys and Questionnaires


  • Pepsinogen C
  • Pepsinogen A