Associations Between Pepsinogen Levels and Various Health Indicators in a Healthy Guangzhou Population

ABSTRACT Background This study investigates the determinants of pepsinogen (PG) levels in a healthy population from Guangzhou, China, aiming to refine its reference interval for better clinical assessment. Methods We analyzed data from 1341 healthy participants to explore the relationship between PG levels and potential influencing factors, including gender, Helicobacter pylori (HP), body weight (BW), body mass index (BMI), body fat rate (BFR), cholesterol (Total cholesterol [TC], triglycerides, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol [LDL‐C]), and glucose (GLU), using both correlation analysis and multivariate linear regression models. Results HP‐positive individuals exhibited higher TC and LDL‐C compared to those without infection ( p < 0.05). A negative correlation was found between the PG ratio and BFR in HP‐positive participants ( p < 0.01). Age positively correlated with PG I levels regardless of HP infection status ( p < 0.05), although this correlation did not hold in postmenopausal women. In males, there was a negative correlation between BW, BMI, and BFR ( p < 0.01); such correlations were absent in females. The PG ratio appeared largely independent of these variables. After multivariate adjustment, age, sex, obesity‐related indices, and HP infection remained independently associated with PG levels. The incidence of precancerous lesions was higher in males (13.73%) compared to females (6.54%; p < 0.05). Conclusion The reference intervals for PG I and II in Guangzhou should account for the interactive effects of age, gender, obesity, and HP infection.