Vascular and autonomic correlates of screening-positive depressive symptom burden in chronic atrophic gastritis: a multicenter observational study protocol

BackgroundDepressive symptoms are common in gastroenterology practice but often missed due to patient stigma and the limitations of self-report questionnaires. This detection gap limits patient access to necessary mental health care. Although vascular dysfunction has been associated with depressive symptoms, the role of accessible peripheral vascular and autonomic measures in relation to concurrent questionnaire-defined depressive symptom burden in gastroenterology settings remains insufficiently studied. This study aims to evaluate whether vascular and autonomic measures are associated with screening-positive depressive symptom burden in chronic atrophic gastritis and whether they may provide adjunctive information beyond conventional clinical and histological variables.Methods and analysisThis multicenter observational protocol plans to enroll 450–520 adults aged 20–60 years with histologically confirmed chronic atrophic gastritis from four centers in China. The study includes dorsalis pedis artery Doppler ultrasonography, brachial–ankle pulse wave velocity assessment, gastrointestinal and histological evaluation, and standardized psychological questionnaires. The primary analysis examines whether vascular and autonomic measures are associated with concurrent screening-positive depressive symptom burden (PHQ-9 ≥ 10) and whether they provide incremental information beyond clinical and histological variables. Multivariable regression and internally validated discrimination analyses are used. No participants have been enrolled and no data have been collected at the time of submission.DiscussionThe findings may help inform future validation studies and multidisciplinary assessment strategies in gastroenterology settings.ConclusionThis study aims to evaluate whether vascular and autonomic measures are associated with screening-positive depressive symptom burden in chronic atrophic gastritis and whether they may provide adjunctive information beyond conventional clinical and histological variables.Clinical trial registration[ClinicalTrials.gov], identifier [NCT07319338].