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Gastric acid secretion of normal Japanese subjects in relation to Helicobacter pylori infection, aging, and gender

Background: In Japan, where the incidence of gastric cancer is high, Helicobacter pylori infection could affect gastric acid secretion differently from that in Western countries. The aim of this study was to investigate the relationship between H. pylori infection, acid secretion, aging, and gender in normal Japanese subjects. Methods: The study comprised 193 Japanese subjects who had undergone routine endoscopy. Gastrin‐stimulated acid output was performed during the routine endoscopic examination using the endoscopic method of gastric acid secretory testing (EGT: endoscopic gastrin test), which has been reported previously. H. pylori status was determined by histology, rapid urease test, and serology. Results: Mean EGT values were 3.9 ± 1.5 mEq/10 min in H. pylori‐negative men, 1.6 ± 2.5 in H. pylori‐positive men, 2.2 ± 0.9 in H. pylori‐negative women, and 1.5 ± 1.2 in H. pylori‐positive women. Although acid secretion was lower in H. pylori‐positive subjects compared with H. pylori‐negative subjects in both men and women, the decrease was more marked in men with H. pylori infection. Multiple linear regression analysis showed that aging is positively associated with gastric acid secretion in the H. pylori‐negative subjects, whereas a negative association was found between them in the H. pylori‐positive subjects. Conclusions: In Japanese subjects, aging affects gastric acid secretion differently depending on the status of H. pylori infection. H. pylori infection showed a stronger inhibitory effect on the acid secretion in men than in women. This gender‐related difference in the susceptibility of acid secretion to H. pylori infection may explain the higher rates of gastric cancer in men in Japan.