Helicobacter pyloriand corpus gastric pathology are associated with lower serum ghrelin

Abstract

AIMTo evaluate the association of Helicobacter pylori (H. pylori), cagA genotype, and type of gastric pathology with ghrelin, leptin and nutritional status.METHODSFasted dyspeptic adults (18-70 years) referred for an upper digestive endoscopy were enrolled in this cross-sectional study. Height and weight were assessed for body mass index (BMI) calculation. A sociodemographic survey was administered and nutrient intake was evaluated with 24 h dietary recalls. Serum total ghrelin and leptin levels were analyzed by enzyme-linked immunosorbent assay. 13C-Urea Breath Test was performed and four gastric biopsies were obtained during endoscopy for histopathology and H. pylori DNA amplification and genotyping. Data analysis was performed using χ2, Mann-Whitney U, Kruskal-Wallis tests, Spearman’s correlation and linear regression.RESULTSOne hundred and sixty-three patients (40.8 ± 14.0 years), 98/65 females/males, were included. Overall, persistent H. pylori prevalence was 53.4% (95%CI: 45.7%-65.8%). Neither nutrient intake nor BMI differed significantly between H. pylori positive and negative groups. Serum ghrelin was significantly lower in infected patients [median 311.0 pg/mL (IQR 230.0-385.5)] than in uninfected ones [median 355.0 pg/mL (IQR 253.8-547.8)] (P = 0.025), even after adjusting for BMI and gender (P = 0.03). Ghrelin levels tended to be lower in patients carrying cagA positive strains both in the antrum and the corpus; however, differences with those carrying cagA negative strains did not reach statistical significance (P = 0.50 and P = 0.49, respectively). In addition, the type and severity of gastric pathology in the corpus was associated with lower serum ghrelin (P = 0.04), independently of H. pylori status. Conversely, leptin levels did not differ significantly between infected and uninfected patients [median 1.84 ng/mL (0.80-4.85) vs 1.84 ng/mL (0.50-5.09), (P = 0.51)].CONCLUSIONH. pylori infection and severity of gastric corpus pathology are associated with lower serum ghrelin. Further studies could confirm a lower ghrelin prevalence in cagA-positive patients.

Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults

“…This is in line with the findings of Eisdorfer et al who found an inverse association between DOB values and BMI in a cross sectional study of 76,000 H. pylori infected participants ( 55 ). Furthermore, increase in BMI following eradication therapy has been observed in some studies ( 58 , 59 ), as well as an inverse association between the hunger inducing hormone ghrelin and H. pylori infection ( 60 , 61 ). On the contrary, observational studies have shown that obesity constitutes a risk factor for H. pylori infection ( 44 , 45 , 62 ).…”

Systematic review with meta‐analysis: association of Helicobacter pylori infection with gastro‐oesophageal reflux and its complications

“…Previous studies have reported that the corpus‐predominant gastritis induced by H. pylori infection, especially by CagA‐positive strain, leads to diminished gastric acid output and, consequently, a reduction in the damaging effect of gastric acid on the oesophagus 58,59 . H. pylori infection may also be associated with decreased gastric production of leptin or ghrelin and, accordingly, reduced gastric acid secretion 60,61 . Moreover, it has been shown that H. pylori DNA can systemically downregulate the pro‐inflammatory responses, such as via type 1 interferon and interleukin‐12 cytokines, 62 potentially leading to a reduced risk of EO.…”

Role of Helicobacter pylori infection in the manifestation of old age‐related diseases

“…These results were parallel with the prevalence of sarcopenia‐associated risk factors obesity, diabetes, increased WBC count and metabolic syndrome. The study by Mantero et al () also predicted that eradication of H. pylori normalizes the levels of ghrelin, thereby suggesting that it might play a significant role in restoring muscle mass.…”