Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-Types of GERD

Abstract Background Gastroesophageal reflux disease (GERD) is a prevalent condition characterized by the troublesome reflux of stomach contents into the esophagus, significantly impacting the quality of life. Pepsin, a protease originating from the stomach, has been implicated in the pathogenesis of GERD and can serve as a potential biomarker for objective assessment. Patients and Methods In this cross-sectional observational study, 45 patients with GERD and 45 healthy volunteers as a control group were examined. Clinical evaluations, laboratory tests, and salivary pepsin measurements were conducted, and esophagogastroduodenoscopy was performed. Results The study revealed a statistically significant increase in body mass index (BMI) among GERD patients (32.2 ± 3.9 kg/m²) compared to the control group (27.8 ± 2.4 kg/m²). Smoking was identified as a significant risk factor for GERD, with 44.5% of GERD patients being smokers compared to 24.4% in the control group. Salivary pepsin levels were significantly higher in GERD patients (108.5 ± 46.6 ng/ml) compared to the control group (24.4 ± 9.9 ng/ml). Additionally, a significant correlation was observed between salivary pepsin levels and the Los Angeles classification of GERD severity. Conclusion This study indicates that obesity negatively impacts esophageal function and smoking is a significant risk factor for GERD. Salivary pepsin levels are significantly elevated in GERD patients and show a strong correlation with GERD severity as classified by the Los Angeles classification system. Salivary pepsin holds promise as a non-invasive biomarker for GERD diagnosis and monitoring.