Asymptomatic Helicobacter Pylori Infection in Preschool Children and Young Women Does Not Predict Iron Bioavailability from Iron-Fortified Foods

Abstract

Helicobacter pylori infection is common in low-income countries. It has been associated with iron deficiency and reduced efficacy of iron supplementation. Whether H. pylori infection affects iron absorption from fortified and biofortified foods is unclear. Our objective was to assess whether asymptomatic H. pylori infection predicts dietary iron bioavailability in women and children, two main target groups of iron fortification programs. We did a pooled analysis of studies in women of reproductive age and preschool children that were conducted in Benin, Senegal and Haiti using stable iron isotope tracers to measure erythrocyte iron incorporation. We used mixed models to assess whether asymptomatic H. pylori infection predicted fractional iron absorption from ferrous sulfate, ferrous fumarate or NaFeEDTA, controlling for age, hemoglobin, iron status (serum ferritin), inflammation (C-reactive protein), and test meal. The analysis included 213 iron bioavailability measurements from 80 women and 235 measurements from 90 children; 51.3% of women and 54.4% of children were seropositive for H. pylori. In both women and children, hemoglobin (Hb), serum ferritin (SF), and C-reactive protein (CRP) did not differ between the seropositive and seronegative groups. Geometric mean (95% CI) fractional iron absorption (%), adjusted for SF, was 8.97% (7.64, 10.54) and 6.06% (4.80, 7.67) in H. pylori positive and negative women (p = 0.274), and 9.02% (7.68, 10.59) and 7.44% (6.01, 9.20) in H. pylori positive and negative children (p = 0.479). Our data suggest asymptomatic H. pylori infection does not predict fractional iron absorption from iron fortificants given to preschool children or young women in low-income settings.

The Association between Helicobacter Pylori Infection and Iron Deficiency Anemia in Children: A Systematic Review and Meta-Analysis

“…1). There were eight cross-sectional studies, 15,17,18,[27][28][29][30][31] six RCTs, 13,[32][33][34][35][36] five case-control studies, 12,16,20,21,37 two surveys, 11,38 and one cohort study. 14 Only six studies reported participants' average age, hemoglobin, and serum ferritin levels 14,20,28,29,31,36 (►Table 2).…”

“…All included studies were of high quality (►Table 3). According to the World Bank classification of economic level, six studies 16,27,[31][32][33]35 with a total sample size of 2,086 were conducted in countries with lower middle incomes. In addition, eight studies 11,14,15,17,28,30,36,38 with a total sample size of 3,990 were from high incomes countries and eight 12,13,18,20,21,29,34,37 with a total sample size of 1,813 were from countries with upper middle incomes.…”

“…Studies included in the meta-analysis were grouped according to the methods used to diagnose H. pylori. In total, 12 studies with a total sample size of 3,728 diagnosed H. pylori using ELISA, [11][12][13]16,17,[27][28][29][30][31]35,38 four studies with a total sample size of 2,295 used a breath test, 15,[32][33][34] and histological examination was used in six studies with a total sample size of 1,866. 14,18,20,21,36,37 ►Figs.…”

Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

“…Die Synthese von Hepcidin scheint bei H. pylori-infizierten Kindern mit Eisenmangel eher hochreguliert zu sein [495]. Eine asymptomatische H. pylori-Infektion hat in der Regel keinen Einfluss auf die Eisenabsorption aus der Nahrung [496]. Daher soll in der Initialdiagnostik kein nicht-invasiver Test auf das Vorliegen einer H. pylori-Infektion durchgeführt werden [464].…”

Treatment of H. pylori infection and gastric ulcer: Need for novel Pharmaceutical formulation

“…Barry Marshall and Robin Warren first identified H. pylori in 1982. In 1989, the bacterium formerly known as Campylobacter pylori ( C.pyloridis ) was reclassified as H. pylori [ 2 , 3 ]. The proof of concept that H. pylori infection causes gastritis was established through self-experiments involving the ingestion of a bacterial broth, followed by subsequent recovery from gastritis upon eradication of H. pylori , thus verifying Koch's postulates [ 4 ].…”