Urease Levels and Gastritis Stage in Dyspeptic Patients

• Main Authors: Muhammad Miftahussurur, Chyntia Dewi Maharani Putri, Titong Sugihartono, Ari Fahrial Syam, Herry Purbayu, Diah Priyantini, Hartono Kahar, Yudith Annisa Ayu Rezkitha, Iswan Abbas Nusi, Poernomo Boedi Setiawan, Ummi Maimunah, Langgeng Agung Waskito, Ulfa Kholili, Budi Widodo, Amie Vidyani, Husin Thamrin, Gontar Alamsyah Siregar, Reny I'tishom, Tomohisa Uchida, Yoshio Yamaoka
• Format: Article PeerReviewed
• Language: English; English; English
• Published: Indonesian Society of Internal Medicine 2022
• Subjects: RC31-1245 Internal medicine
• Online Access: https://repository.unair.ac.id/125570/1/10.Urease_Levels_and.pdf; https://repository.unair.ac.id/125570/2/10.Karil_Urease_Levels_and.pdf; https://repository.unair.ac.id/125570/3/10.Similarity_Urease_Levels_and.pdf; https://repository.unair.ac.id/125570/; https://www.actamedindones.org/index.php/ijim/article/view/1927
• Institution: Universitas Airlangga

Background: Dyspepsia is a frequent main symptom of inpatients and outpatients scenario in Indonesia. However, the number of endoscopy facilities are still low, thus the use of non-invasive method to detect gastritis is necessary. We measured the relationship between urease levels and the stage of gastritis in dyspeptic adult patients. Methods: A cross-sectional study included outpatient dyspepsia patient from November 2018 to February 2019. We examined 14C-Urea Breath Test (UBT) and determined the stage of gastritis based on the Updated Sydney System classification. Results: The urease level of acute and chronic gastritis positive patients were higher than negative patients (p = 0.001, r = 0.353; p <0.0001, r = 0.433, respectively). The AUC value of 14C-UBT to detect acute, chronic, and atrophic gastritis are 0.889, 0.632 and 0.544, respectively. The best cut-off points of 14C-UBT to predict acute gastritis was ≥26.50δ‰ with sensitivity and specificity being 88.89% and 63.95%, respectively. Whereas the best cut-off points for chronic gastritis was ≥34.50δ‰ with 82.89% sensitivity, 63.16% specificity. As for atrophic gastritis, it showed very low AUC value, hence it is not a sufficient test modality to predict atrophic gastritis cases. Conclusion: 14C-UBT is sufficient for predicting acute or chronic gastritis but not for atrophic gastritis.