BackgroundHelicobacter pylorisecretes cytotoxin-associated gene A (CagA) into the gastric epithelium, causing gastric mucosal atrophy (GMA) and gastric cancer. In contrast, host cells degrade CagA via autophagy. However, the association between polymorphisms in autophagy-related genes and GMA must be fully elucidated.ResultsWe evaluated the association between single nucleotide polymorphisms (SNPs) in autophagy-related genes (low-density lipoprotein receptor-related protein 1,LRP1; capping actin protein of muscle Z-line alpha subunit 1,CAPAZ1; and lysosomal-associated membrane protein 1,LAMP1) and GMA in 200H. pylori-positive individuals. The frequency of the T/T genotype at rs1800137 inLRP1was significantly lower in the GMA group than in the non-GMA group (p= 0.018, odds ratio [OR] = 0.188). The frequencies of the G/A or A/A genotype at rs4423118 and T/A or A/A genotype at rs58618380 ofCAPAZ1in the GMA group were significantly higher than those in the non-GMA group (p= 0.029 andp= 0.027, respectively). Multivariate analysis revealed that C/C or C/T genotype at rs1800137, T/A or A/A genotype at rs58618380, and age were independent risk factors for GMA (p= 0.038,p= 0.023, andp= 0.006, respectively). Furthermore, individuals with the rs1800137 C/C or C/T genotype ofLRP1had a 5.3-fold higher susceptibility to GMA. These genetic tests may provide future directions for precision medicine for individuals more likely to develop GMA.ConclusionLRP1andCAPZA1polymorphisms may be associated with the development of GMA.