Metabolic Dysregulation and Risk Predictors of Peptic Ulcer Disease: A Clinical and Biochemical Analysis

Background: Peptic ulcers are excruciating erosions of the stomach or intestinal lining that can cause bleeding and long-term discomfort, among other major health risks. Aim: The purpose of this study was to identify predictors, risk factors, and biochemical indicators associated with increased peptic ulcer disease (PUD) in adult Iraqis. Methods: The study involved 110 participants (mean age: 39 years) who underwent gastrointestinal endoscopy, consisting of 40 healthy controls and 70 patients with peptic ulcer disease (PUD). Demographic characteristics and hepatopancreatic enzyme levels were assessed. The study was conducted from July to October 2024 at Marjan Teaching Hospital and affiliated gastrointestinal clinics. Results: PUD patients showed higher cholesterol, triglycerides, and LDL levels, along with lower HDL. Vitamin D deficiency (<20 ng/mL) was a major risk factor, with ulcer patients exhibiting significantly lower levels (15 vs. 26 ng/mL) and a sixfold increase in ulcer risk. Elevated pancreatic amylase (94 vs. 82 U/L), while slightly lower than liver enzymes. Additionally, PUD risk was strongly associated with H. pylori infection (OR 4.24, p = 0.001) and current smoking (OR 3.96, p = 0.001). Discussion: Vitamin D deficiency emerged as the strongest PUD risk factor, impacting gut mucosal integrity and oxidative stress regulation. It also affects tight junction proteins, reducing bacterial translocation and mucosal damage. Additionally, hypercholesterolemia and smoking were linked to higher ulcer risk, underscoring metabolic and lifestyle intervention needs. Conclusions: The conclusion underscores the impact of vitamin D deficiency, dyslipidemia, and pancreatic enzyme changes in exacerbating oxidative stress and compromising gut mucosal integrity in PUD.