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Kolasa-Kicińska M, Stawerska R, Stawerski P, Kałużyński A, Czkwianianc E, Lewiński A. Effects of Helicobacter pylori Infection on Ghrelin and Insulin-like Growth Factor 1 Secretion in Children with Idiopathic Short Stature. J Clin Med 2022; 11:5868. [PMID: 36233735 PMCID: PMC9572010 DOI: 10.3390/jcm11195868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A diagnosis of "idiopathic short stature" (ISS) in a child means that the cause of the disease has not been established, although there are certainly some unknown factors that contributed to its occurrence. Ghrelin and leptin are important in controlling food intake; ghrelin is also a growth hormone (GH) stimulator. Both enterohormones are produced in the stomach and their secretion may be affected by a Helicobacter pylori (H. pylori) infection. METHODS Our study included a group of 61 children (53 prepubertal and 8 peripubertal) with ISS, without any gastrointestinal tract symptoms but in whom the histopathological evaluation of stomach tissue was made during gastroscopy to diagnose H. pylori infection. In each child, fasting ghrelin, leptin and IGF-1 concentrations, and GH levels in two stimulation tests were assessed. RESULTS H. pylori infection was confirmed in 24.6% of the children. Ghrelin and IGF-1 concentrations were significantly lower in H. pylori-positive than H. pylori-negative children (this was more noticeable in prepubertal subgroups), however there was not a discrepancy in regards to GH concentrations in stimulation tests, leptin levels or the nutritional state between groups. CONCLUSIONS Short children, infected by H. pylori seem to have lower ghrelin and IGF-1 concentrations than children without infection, this may be the reason for a worse growth rate in this subgroup.
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Affiliation(s)
- Marzena Kolasa-Kicińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital–Research Institute, 93-338 Lodz, Poland
| | - Renata Stawerska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital–Research Institute, 93-338 Lodz, Poland
- Department of Paediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland
| | - Paweł Stawerski
- Consilio Diagnostyka, Laboratory of Histopathology, 93-357 Lodz, Poland
| | - Andrzej Kałużyński
- Department of Clinical Pathomorphology, Polish Mother’s Memorial Hospital–Research Institute, 93-338 Lodz, Poland
| | - Elżbieta Czkwianianc
- Department of Gastroenterology, Allergology and Paediatrics, Polish Mother’s Memorial Hospital–Research Institute, 93-338 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital–Research Institute, 93-338 Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 93-338 Lodz, Poland
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Xu C, Wu Y, Xu S. Association between Helicobacter pylori infection and growth outcomes in children: A meta-analysis. Helicobacter 2022; 27:e12861. [PMID: 34997950 DOI: 10.1111/hel.12861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multiple studies have reported the association between Helicobacter pylori (H. pylori) infection and children's growth. The results of these studies are controversial. Our meta-analysis aimed to evaluate the association between H. pylori infection and growth outcomes in children. METHODS We searched PubMed, Embase, Web of Science, and Cochrane Library, as well as two Chinese databases, Wanfang, and CNKI from inception to September 2019. Odds ratios (ORs) and standardized mean differences (SMDs) with their 95% confidence interval (95% CI) were selected as the effect size. We assessed pooled data using a random-effects model. Subgroup and sensitivity analyses were conducted. RESULTS In total, 29 studies provided data from 9384 subjects. The meta-analysis results indicated a significant association of H. pylori infection with ponderal growth disorders (OR: 2.47; 95% CI: 1.13, 5.37; p = 0.02) and linear growth disorders (OR =1.76; 95% CI: 1.15, 2.69, p = 0.01). H. pylori infection has an adverse impact on children's height-for-age Z (HAZ) scores (SMD = -0.41; 95% CI: -0.69, -0.13; p < 0.01). Pooling SMDs by other outcomes (height, weight, BMI, weight-for-age and BMI-for-age Z scores, weight-for-age percentile scores, and linear and ponderal growth velocity with/without infection and eradication/non-eradication) all indicated no significant association. CONCLUSION The current evidence supports the hypothesis that H. pylori infection is associated with growth outcomes in children, mainly HAZ scores. Clinicians might consider H. pylori infection in investigating linear growth disorders in children.
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Affiliation(s)
- Chenjing Xu
- Department of Gastroenterology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yao Wu
- Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shunfu Xu
- Department of Gastroenterology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Effect of Helicobacter Pylori Infection on Nutritional Status in Polish Teenagers. Gastroenterol Res Pract 2021; 2021:6678687. [PMID: 33859683 PMCID: PMC8024096 DOI: 10.1155/2021/6678687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/04/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Data on an association between Helicobacter pylori (H. pylori) and nutritional status in children are conflicting. We designed a large-sampled prospective community-based study to examine the differences in average body indices among Polish teenagers depending on their H. pylori status. Methods From September 2008 to June 2015, 3067 second junior high school students aged between 13 and 17 years (mean age: 14.5) from 11 randomly selected schools from Grudziadz, Poland, were recruited. For the cohort, 13C urea breath test for current H. pylori infection was performed and data on anthropometric measurements and sociodemographic characteristics were collected. Z scores of height for age (HAZ), weight for age (WAZ), and BMI for age (BMIZ) were calculated. Results The H. pylori colonisation rate was 23.6% with no gender difference. Compared to noninfected, H. pylori infected had significantly lower mean WAZ (0.0085) and BMIZ scores (p = 0.0246). Univariate linear regression models showed that living in the old town district and consumption of tap water were negative predictors of HAZ, living in the old town district, using collective catering facilities, and H. pylori infection were negative predictors of WAZ, and using collective catering facilities and H. pylori infection were negative predictors of BMIZ. In the multiple regression analyses, living in the old town district (p = 0.0039), using collective catering facilities (p < 0.0001), and H. pylori infection (p = 0.0269) were confirmed to be independently associated with lower WAZ, whereas using collective catering facilities (p < 0.0001) and H. pylori infection (p = 0.0265) were confirmed to be independently associated also with lower BMIZ. Conclusion Our finding confirms the evidence on independent negative influence of H. pylori infection on nutritional status in Polish teenagers.
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Crowley E, Hussey S. Helicobacter pylori in Childhood. PEDIATRIC GASTROINTESTINAL AND LIVER DISEASE 2021:275-292.e12. [DOI: 10.1016/b978-0-323-67293-1.00027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Chobot A, Porębska J, Krzywicka A, Żabka A, Bąk-Drabik K, Pieniążek W, Dubik A, Adamczyk P, Kwiecień J. No association between Helicobacter pylori infection and gastrointestinal complaints in a large cohort of symptomatic children. Acta Paediatr 2019; 108:1535-1540. [PMID: 30656740 DOI: 10.1111/apa.14721] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 11/05/2018] [Accepted: 01/11/2019] [Indexed: 12/12/2022]
Abstract
AIM This Polish study estimated the prevalence of the Helicobacter pylori infection in symptomatic children aged 3-18 and investigated its association with gastrointestinal complaints. METHODS We prospectively enrolled 1984 children (54% female) with a mean age of 9.5 ± 4.1 years, from Silesia, Poland, for the Good Diagnosis Treatment Life screening programme from 2009 to 2016. They underwent a 13 C-isotope-labelled urea breath test (UBT) to assess their Helicobacter pylori status, making this the biggest Polish study to use this approach. Further analysis included parental-reported gastrointestinal symptoms and standard deviation scores (SDS) of anthropometric measurements. RESULTS The Helicobacter pylori infection was identified in 220 (11%) children (48% female) and was independent of age and sex. The frequency of symptoms did not differ between Helicobacter positive and negative children (all p > 0.05). Children with a positive UBT result had a lower body mass SDS (-0.41 ± 0.98 versus -0.26 ± 1.01, p = 0.04) and height SDS (-0.45 ± 1.34 versus -0.23 ± 1.27, p = 0.02), but similar body mass index SDS. CONCLUSION We found a low prevalence of Helicobacter pylori in symptomatic children, and positive UBT results were not associated with symptoms that suggested Helicobacter pylori infections. Our findings support the 2017 European and North American guidelines for Helicobacter infections in children.
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Affiliation(s)
- Agata Chobot
- Department of Paediatrics; Institute of Medicine; University of Opole; Opole Poland
| | | | | | | | - Katarzyna Bąk-Drabik
- Chair and Department of Paediatrics; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | | | | | - Piotr Adamczyk
- Chair and Department of Paediatrics; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Jarosław Kwiecień
- Chair and Department of Paediatrics; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
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Abstract
BACKGROUND In adults, Helicobacter pylori is aetiologically associated with peptic ulcer disease and gastric cancer. However, the relationship between this bacteria and gastro-intestinal symptoms in children is less clear. AIMS To review the recent literature on H. pylori in children and to outline the approach to diagnosis and management. METHODS The English language literature was searched for articles on H. pylori in children. Special attention was paid to prevalence, diagnosis and management pertinent to low- and middle-income countries (LMIC). RESULTS Although the prevalence of H. pylori is 60-80% in LMIC, only 5% of infected children develop peptic ulcer disease. The virulence of the organism determines the outcome. There is a suggestion that H. pylori causes iron deficiency anaemia, growth retardation and idiopathic thrombocytopenic purpura, but the evidence is not sufficiently strong to justify screening. There is no evidence to suggest a link between H. pylori infection and recurrent abdominal pain. Endoscopy (with invasive tests) is the preferred method of investigation as the primary goal is to determine the underlying cause of the symptoms. Children with H. pylori-related diseases should be treated with a standard triple-drug regimen consisting of a protein pump inhibitor and two antibiotics for 10-14 days. All treated patients should be monitored for eradication with non-invasive tests such as the urea (13-C) breath test or stool antigen tests. CONCLUSIONS Although H. pylori infection is common in LMIC, most children are asymptomatic. There is no association between H. pylori and recurrent abdominal pain. Invasive tests are preferred for diagnosis and a triple-drug regimen is the treatment of choice.
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Affiliation(s)
- Ujjal Poddar
- a Department of Paediatric Gastroenterology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
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Selbuz S, Kırsaçlıoğlu CT, Kuloğlu Z, Yılmaz M, Penezoğlu N, Sayıcı U, Altuntaş C, Kansu A. Diagnostic Workup and Micronutrient Deficiencies in Children With Failure to Thrive Without Underlying Diseases. Nutr Clin Pract 2019; 34:581-588. [PMID: 30644589 DOI: 10.1002/ncp.10229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES AND STUDY Failure to thrive (FTT) is an interruption in the normal pattern of growth. We aimed to evaluate the clinical characteristics, underlying etiologies, diagnostic workup, and frequency of micronutrient deficiencies (MDs) in children with FTT. METHODS This retrospective study was done with 729 children (319 male, mean age 6.8 ± 5.5 years) with FTT (weight for age <3rd percentile) who had visited the Pediatric Gastroenterology outpatient clinic between 2011 and 2016. Children who had previously known chronic diseases, inadequate intake, or inadequate absorption were excluded. Acute malnutrition was considered if weight-for-age z-scores were below -2 and height-for-age z-scores were above -2, and chronic malnutrition was defined if height-for-age z-scores were below -2. RESULTS The malnutrition rate was 57.1% (acute: 37.8%, chronic: 19.3%). Of children, 98.7% had laboratory evaluation. We found that 1.1% of laboratory tests, 0.4% of imaging studies, 27% of endoscopic findings, and biopsy results led to a specific diagnosis, equating to a total of 1.3% of diagnostic workup leading to a diagnosis related to FTT. The causes of FTT were inadequate nutrition (61.4%), psychiatric and behavioral disorders (17.2%), endocrinologic disorders (9%), recurrent infections (6.4%), gastrointestinal diseases (1.9%), and cardiac disorders (0.1%). Vitamin A and D deficiencies were the most common MD. CONCLUSION We showed that the most common cause of FTT is "purely nutrition" FFT because of inadequate caloric intake, and extensive diagnostic workup is rarely helpful to reveal the etiology. These results implicate the importance of clinical evaluation and anthropometry to evaluate a child with FTT.
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Affiliation(s)
- Suna Selbuz
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | | | - Zarife Kuloğlu
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | - Mustafa Yılmaz
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | - Nilay Penezoğlu
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | - Ufuk Sayıcı
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | - Cansu Altuntaş
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
| | - Aydan Kansu
- Ankara University, Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara, Turkey
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Chiu NC, Lin CY, Chi H, Yeung CY, Ting WH, Chan WT, Jiang CB, Li ST, Lin CH, Lee HC. Helicobacter pylori infection is not associated with failure to thrive: a case control study. Ther Clin Risk Manag 2017; 13:273-278. [PMID: 28260914 PMCID: PMC5328124 DOI: 10.2147/tcrm.s123148] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose The long-term impact of Helicobacter pylori infection is complex, and concerns about the need for eradication exist. We conducted this case control study to investigate the association between H. pylori infection and failure to thrive (FTT). Patients and methods From January 2009 to December 2011, 53 children with FTT group and matched children with the same sex and age and similar socioeconomic status without FTT (control group) were enrolled. A questionnaire was administered to the parents/guardian, and a 13C-urea breath test was performed to detect H. pylori infection. Results We found that the total prevalence of H. pylori infection was 29.2% and that there was no association between FTT and H. pylori infection (FTT group: 32%; control group: 26.4%; P=0.67). Short stature was more common in the FTT group and abdominal pain in the control group (FTT group: 37.7%; control group: 11.3%; P=0.003). In a comparison between the H. pylori-positive and -negative groups, abdominal pain (87.1% vs 64%; P=0.032) and the frequency of endoscopy (74.2% vs 32%; P<0.001) were significantly more common in the H. pylori-positive group. Conclusion We found that children with H. pylori infection are at an increased risk for abdominal pain and that FTT is not associated with H. pylori infection. The decision for eradication should be evaluated carefully and individualized.
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Affiliation(s)
- Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital; Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei
| | - Chien-Yu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City
| | - Hsin Chi
- Department of Pediatrics, MacKay Children's Hospital
| | - Chun-Yan Yeung
- Department of Pediatrics, MacKay Children's Hospital; Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei
| | - Wei-Hsin Ting
- Department of Pediatrics, MacKay Children's Hospital
| | - Wai-Tao Chan
- Department of Pediatrics, MacKay Children's Hospital
| | | | - Sung-Tse Li
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City; Department of Statistics and Information Science, Fu Jen Catholic University, New Taipei, Taiwan
| | - Chao-Hsu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City
| | - Hung-Chang Lee
- Department of Pediatrics, MacKay Children's Hospital; Department of Medicine, MacKay Junior College of Medicine, Nursing and Management, Taipei
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Impact of Helicobacter pylori Immunoglobulin G Levels and Atrophic Gastritis Status on Risk of Metabolic Syndrome. PLoS One 2016; 11:e0166588. [PMID: 27851820 PMCID: PMC5113018 DOI: 10.1371/journal.pone.0166588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/31/2016] [Indexed: 12/16/2022] Open
Abstract
Background Helicobacter pylori (HP) infection is implicated in gastric and extra-gastric diseases. While gastritis-related chronic inflammation represents a known trigger of metabolic disturbances, whether metabolic syndrome (MetS) is affected by gastritis status remains unclear. We aimed to clarify the effect of HP-related gastritis on the risk of MetS. Materials and Methods We retrospectively enrolled patients undergoing screening for MetS between 2014 and 2015. Investigations included HP-specific immunoglobulin G (IgG) antibody assays to detect HP infection, and serum pepsinogen assays to evaluate atrophic gastritis status. The risk of MetS was evaluated via multiple logistic regression analyses with two covariates: serum HP infection status (IgG levels) and atrophic gastritis status (two criteria were applied; pepsinogen I/II ratio < 3 or both pepsinogen I levels ≤ 70 μg/L and pepsinogen I/II ratio < 3). Results Of 1,044 participants, 247 (23.7%) were HP seropositive, and 62 (6.0%) had MetS. HP seronegative and seropositive patients had similar risks of MetS. On the other hand, AG (defined in terms of serum PG I/II <3) was significant risk of MetS (OR of 2.52 [95% CI 1.05–7.52]). After stratification according to HP IgG concentration, patients with low HP infection status had the lowest MetS risk (defined as an odds ratio [OR] adjusted for age, sex, smoking, drinking and physical activity status). Taking this result as a reference, patients with negative, moderate, and high HP infection status had ORs (with 95% confidence intervals [CI]) of 2.15 (1.06–4.16), 3.69 (1.12–16.7), and 4.05 (1.05–26.8). Conclusions HP-associated gastritis represents a risk factor for MetS. Research should determine why low and not negative HP infection status is associated with the lowest MetS risk.
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Müller I, Yap P, Steinmann P, Damons BP, Schindler C, Seelig H, Htun NSN, Probst-Hensch N, Gerber M, du Randt R, Pühse U, Walter C, Utzinger J. Intestinal parasites, growth and physical fitness of schoolchildren in poor neighbourhoods of Port Elizabeth, South Africa: a cross-sectional survey. Parasit Vectors 2016; 9:488. [PMID: 27595566 PMCID: PMC5011914 DOI: 10.1186/s13071-016-1761-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 08/16/2016] [Indexed: 12/11/2022] Open
Abstract
Background As traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa. Methods We conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined. Results Complete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg-1 min-1, compared to 51.5 and 47.4 ml kg-1 min-1 for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l-1. In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l-1, respectively. Conclusions Intestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1761-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ivan Müller
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.,Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland
| | - Peiling Yap
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.,Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 308433, Singapore, Singapore
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland
| | - Bruce P Damons
- Faculty of Education, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa.,Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland
| | - Harald Seelig
- University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.,Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland
| | - Nan S N Htun
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland
| | - Markus Gerber
- University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.,Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa
| | - Uwe Pühse
- University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.,Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
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Effect of Helicobacter pylori infection on growth trajectories in young Ethiopian children: a longitudinal study. Int J Infect Dis 2016; 50:57-66. [PMID: 27531186 DOI: 10.1016/j.ijid.2016.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/15/2016] [Accepted: 08/08/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection has been associated with early childhood growth impairment in high- and middle-income countries; however, few studies have examined this relationship within low-income countries or have used a longitudinal design. The possible effects of H. pylori infection on growth trajectories were examined in a cohort of young Ethiopian children. METHODS In 2011/12, 856 children (85.1% of the 1006 original singletons in a population-based birth cohort) were followed up at age 6.5 years. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Height and weight were measured twice, and the average of the two measurements was used. Exposure to H. pylori infection was assessed using a rapid H. pylori stool antigen test. The independent associations of positive H. pylori infection status (measured at ages 3 and 6.5 years) with baseline height and weight (age 3 years) and height and weight growth trajectory (from age 3 to 6.5 years) were modelled using hierarchical linear models. RESULTS At baseline (age 3 years), the children's mean height was 85.7cm and their mean weight was 11.9kg. They gained height at a mean rate of 8.7cm/year, and weight at a mean rate of 1.76kg/year. H. pylori infection was associated with lower baseline measurements and linear height trajectory (β=-0.74cm and -0.79cm/year, respectively), after controlling for demographics and markers of socio-economic status. However, the positive coefficient was associated with quadratic growth in height among H. pylori-infected children (β=0.28, 95% confidence interval 0.07 to 0.49, p<0.01), and indicated an increase in height trajectory as the child increased in age. A non-significant difference in baseline and trajectory of weight was observed between H. pylori-infected and non-infected children. CONCLUSIONS These findings add to the growing body of evidence supporting that H. pylori infection is inversely associated with childhood growth trajectory, after controlling for a range of factors associated with reduced growth and H. pylori status. Further follow-up will be important to confirm possible catch-up in height trajectory among H. pylori-infected children as they grow older.
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Erdemir G, Ozkan TB, Ozgur T, Altay D, Cavun S, Goral G. Helicobacter pylori Infection in Children: Nutritional Status and Associations with Serum Leptin, Ghrelin, and IGF-1 Levels. Helicobacter 2016; 21:317-24. [PMID: 26667121 DOI: 10.1111/hel.12288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Helicobacter pylori is associated with gastrointestinal diseases such as gastritis, peptic ulcers, malignancy and lymphoma, and extra-gastrointestinal conditions. H. pylori infection is negatively associated with children's growth. Chronic inflammation of the stomach that results in the loss of appetite and, dysregulation of neuroendocrine hormones such as leptin, and ghrelin are the probable reasons of this negative association. The objective of this study is to determine the serum levels of leptin, ghrelin, and IGF-1 in H. pylori-infected children and their relations with growth. MATERIALS AND METHODS A hundred and sixty-one school children aged between 6 and 14 years were selected randomly from five primary schools representing a cross section of population. Demographic and sociocultural characteristics, and anthropometric measurements were recorded. Serum H. pylori IgG, insulin-like growth factor-1, leptin, and ghrelin levels were measured in all children. The children were grouped according to the nutritional status and Helicobacter pylori seropositivity. Nutritional indices were compared among groups in association with serum leptin, ghrelin, and insulin-like growth factor-1 levels. RESULTS H. pylori IgG positivity was found in 34.2%, and 14.9% of children were malnourished. H. pylori seropositivity was significantly higher in older ages (10.32 ± 2.26 vs 9.53 ± 2.36 years, p = .036), and body weight and height Z scores were significantly lower in H. pylori-seropositive children (-0.33 ± 1.08 vs 0.04 ± 1.26, p = .044 and 0.13 ± 0.92 vs 0.23 ± 0.91, p = .018 respectively). H. pylori seropositivity was found to be an independent risk factor for shorter body height (p = .01). Serum leptin, ghrelin, and IGF-1 levels were not associated with H. pylori IgG seropositivity (0.35 vs 0.55 ng/mL, p = .3; 3267.4 ± 753.0 vs 2808.3 ± 911.4 pg/mL, p = .06; 470 ± 176 vs 521 ± 179 ng/mL, p = .32, respectively). CONCLUSIONS Children infected with H. pylori are prone to short stature. This effect seems to be independent of neuroendocrine hormones.
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Affiliation(s)
- Gulin Erdemir
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey
| | - Tanju Basarir Ozkan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey
| | - Taner Ozgur
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey
| | - Derya Altay
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey
| | - Sinan Cavun
- Department of Medical Pharmacology, Uludag University Medical Faculty, Bursa, Turkey
| | - Guher Goral
- Department of Microbiology, Uludag University Medical Faculty, Bursa, Turkey
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Abstract
OBJECTIVES Helicobacter pylori infection is acquired in early childhood, yet its role in children's health is still not fully clear. In this narrative review, we focused on the association between H pylori infection and children's growth. METHODS A literature search of the Ovid MEDLINE (till June 2015) and EMBASE (till August 2015) databases was performed using the terms "Helicobacter pylori, growth, body height, growth disorders and child development." Original studies that addressed the association between H pylori infection or eradication and children's growth were reviewed and the risk of bias of each study was assessed. RESULTS The existing evidence is based on observational studies (N = 48) and suggests that H pylori infection may adversely influence children's growth; findings were more consistent across studies with low risk of bias. Regarding linear growth, observational studies have repeatedly linked between H pylori infection and slower or diminished linear growth; yet, it is not known whether this association is causal. The association between H pylori infection and ponderal growth has been less consistent. Scarce evidence exists on the effect of H pylori eradication on children's skeletal growth and weight gain, but there is an indication that H pylori eradication may benefit nutritional status. CONCLUSIONS H pylori infection may impair children's growth. Additional studies, especially clinical trials, are needed to elucidate the role of H pylori eradication in children's growth, and the mechanisms that may be involved in such.
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Abstract
BACKGROUND There are conflicting results regarding the role of H. pylori in children's growth. We examined differences in growth indices at school age according to H. pylori infection acquisition in preschool age. MATERIALS AND METHODS A prospective study was undertaken between 2004 and 2009, in which of healthy children (N = 139, ages 3-5 years at baseline) were tested for the presence of H. pylori antigen in their stool using enzyme-linked immunoassay and followed-up till age 6-9 years (median follow-up time 45 months). Height, weight, and hemoglobin levels were measured, and socioeconomic data were obtained. Z scores of height for age, weight for age, and body mass index for age at baseline and follow-up were calculated using the 2000 Center for Disease Control and Prevention growth reference curves. Growth velocity (cm/month) between preschool and school age was compared between H. pylori-infected and uninfected children using mixed models. RESULTS Fifty-three percent of the children were H. pylori positive at baseline, and all except one child tested positive at follow-up. The adjusted mean Z score of height for age at follow-up was significantly lower among H. pylori-infected children than uninfected ones: 0.15 (95% confidence intervals (CIs) 0.02, 0.29) and 0.45 (95% CI 0.29, 0.60), respectively (p = .002). Growth velocity was slower in the former group -0.0264 cm/month (95% CI -0.047, -0.005) (p = .014), after adjusting for baseline height and age. H. pylori infection was not associated with body weight. CONCLUSIONS Helicobacter pylori infection acquired in early childhood may have long-term adverse influence on linear growth at school age.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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15
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Ali AM, Elkhatib WF. Potential Complications of Helicobacter pylori Infection in Children of a Non-Urban Community. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2015; 3. [DOI: 10.5812/pedinfect.23510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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16
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Dietary and anthropometric indicators of nutritional status in relation to Helicobacter pylori infection in a paediatric population. Br J Nutr 2015; 113:1113-9. [PMID: 25761510 DOI: 10.1017/s0007114515000483] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It has been postulated that Helicobacter pylori infection could affect growth and appetite, consequently influencing body weight. Therefore, the association between H. pylori infection and the dietary and anthropometric indicators of nutritional status of a paediatric population were investigated. A total of 525 children (aged 4-16 years) who were referred to the gastroenterology unit of the Sor Maria Ludovica Children's Hospital from Buenos Aires, Argentina, were enrolled and completed an epidemiological questionnaire. H. pylori infection was diagnosed using the ¹³C-urea breath test (¹³C-UBT). Height and weight were assessed for calculation of anthropometric indicators. Energy and macronutrient intakes were estimated by 24 h dietary recall. Data analysis was performed using a χ² test, a Student's t test, a Mann-Whitney U test and linear and logistic regressions. The prevalence of H. pylori infection was 25·1 % (with a mean age of 10·1 (SD 3·1) years). A tendency towards lower energy, carbohydrate, protein and fat intakes was observed in infected patients; however, it was not associated with H. pylori infection in any of the evaluated age groups (4-8, 9-13 and 14-16 years). Underweight, stunting, overweight and obesity were also not associated with the infection. Although height-for-age and BMI-for-age Z scores tended to be lower in infected patients, the differences between H. pylori-positive and H. pylori-negative children were not statistically significant. In conclusion, H. pylori infection was not associated with dietary intake or with anthropometric indicators in the present population of children with gastrointestinal symptoms; however, an increased sample size would be needed to confirm the observed tendency towards lower dietary intake and lower anthropometric indicators of nutritional status in H. pylori-infected children.
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17
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Buzás GM. Metabolic consequences of Helicobacter pylori infection and eradication. World J Gastroenterol 2014; 20:5226-5234. [PMID: 24833852 PMCID: PMC4017037 DOI: 10.3748/wjg.v20.i18.5226] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is still the most prevalent infection of the world. Colonization of the stomach by this agent will invariably induce chronic gastritis which is a low-grade inflammatory state leading to local complications (peptic ulcer, gastric cancer, lymphoma) and remote manifestations. While H. pylori does not enter circulation, these extragastric manifestations are probably mediated by the cytokines and acute phase proteins produced by the inflammed mucosa. The epidemiologic link between the H. pylori infection and metabolic changes is inconstant and controversial. Growth delay was described mainly in low-income regions with high prevalence of the infection, where probably other nutritional and social factors contribute to it. The timely eradication of the infection will lead to a more healthy development of the young population, along with preventing peptic ulcers and gastric cancer An increase of total, low density lipoprotein and high density liporotein cholesterol levels in some infected people creates an atherogenic lipid profile which could promote atherosclerosis with its complications, myocardial infarction, stroke and peripheral vascular disease. Well designed and adequately powered long-term studies are required to see whether eradication of the infection will prevent these conditions. In case of glucose metabolism, the most consistent association was found between H. pylori and insulin resistance: again, proof that eradication prevents this common metabolic disturbance is expected. The results of eradication with standard regimens in diabetics are significantly worse than in non-diabetic patients, thus, more active regimens must be found to obtain better results. Successful eradication itself led to an increase of body mass index and cholesterol levels in some populations, while in others no such changes were encountered. Uncertainities of the metabolic consequences of H. pylori infection must be clarified in the future.
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18
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Abstract
Cancer of the stomach is the fourth most common cancer worldwide. The single strongest risk factor for gastric cancer is Helicobacter pylori-associated chronic gastric inflammation. Among persons with H. pylori infection, strain-specific components, host immune responses, and environmental factors influence the risk for gastric disease, including adenocarcinoma of the stomach, although only a small proportion of infected persons develop the malignancy. Recent advances in DNA sequencing technology have uncovered a complex community of noncultivatable inhabitants of the human stomach. The interaction between these inhabitants, collectively referred to as the gastric microbiota, and H. pylori likely affects gastric immunobiology and possibly the sequelae of H. pylori infection. Thus, characterization of the gastric microbiota in subjects with and without H. pylori infection could provide new insight into gastric homeostasis and the pathogenesis of H. pylori-associated disease, including gastric cancer.
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Affiliation(s)
- Kyle M. Brawner
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Casey D. Morrow
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Phillip D. Smith
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294
- Department of VA Medical Center Research Service, Birmingham, AL 35233
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19
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Pacifico L, Osborn JF, Tromba V, Romaggioli S, Bascetta S, Chiesa C. Helicobacter pylori infection and extragastric disorders in children: a critical update. World J Gastroenterol 2014; 20:1379-401. [PMID: 24587617 PMCID: PMC3925850 DOI: 10.3748/wjg.v20.i6.1379] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/10/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in the last decades, abetted by modern clinical practices, may have other health consequences.
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20
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Queiroz DMM, Rocha AMC, Crabtree JE. Unintended consequences of Helicobacter pylori infection in children in developing countries: iron deficiency, diarrhea, and growth retardation. Gut Microbes 2013; 4:494-504. [PMID: 23988829 PMCID: PMC3928161 DOI: 10.4161/gmic.26277] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Helicobacter pylori infection is predominantly acquired early in life. The prevalence of the infection in childhood is low in developed countries, whereas in developing countries most children are infected by 10 y of age. In poor resource settings, where malnutrition, parasitic/enteropathogen and H. pylori infection co-exist in young children, H. pylori might have potentially more diverse clinical outcomes. This paper reviews the impact of childhood H. pylori infection in developing countries that should now be the urgent focus of future research. The extra-gastric manifestations in early H. pylori infection in infants in poor resource settings might be a consequence of the infection associated initial hypochlorhydria. The potential role of H. pylori infection on iron deficiency, growth impairment, diarrheal disease, malabsorption and cognitive function is discussed in this review.
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Affiliation(s)
- Dulciene MM Queiroz
- Laboratory of Research in Bacteriology; Faculdade de Medicina; Universidade Federal de Minas Gerais; Belo Horizonte, Brazil
| | - Andreia MC Rocha
- Laboratory of Research in Bacteriology; Faculdade de Medicina; Universidade Federal de Minas Gerais; Belo Horizonte, Brazil
| | - Jean E Crabtree
- Leeds Institute Molecular Medicine; St. James’s University Hospital; University of Leeds; Leeds, UK,Correspondence to: Jean E Crabtree,
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21
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Dehghani SM, Karamifar H, Raeesi T, Haghighat M. Growth parameters in children with dyspepsia symptoms and Helicobacter pylori infection. Indian Pediatr 2012; 50:324-6. [PMID: 23024103 DOI: 10.1007/s13312-013-0090-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 06/06/2012] [Indexed: 02/05/2023]
Abstract
Controversy exists about relationship of H. pylori infection and somatic growth retardation of children. The aim of this study was to evaluate the relationship between H. pylori infection and growth parameters in children. 113 children with dyspepsia (4-18 years) were enrolled. C13 urea breath test was performed for determination of H.pylori infection. Height, weight, body mass index (BMI) and standard deviation score (SDS) was calculated and growth parameters were compared between two groups of H.pylori positive and those with negative results. The prevalence of H.pylori infection was 52.2%. There was no meaningful relation between calculated SDS (for height and BMI) and H.pylori infection.
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Affiliation(s)
- Seyed Mohsen Dehghani
- Department of Pediatric Gastroenterology, and Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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22
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Abstract
BACKGROUND A new Helicobacter pylori infection affects growth velocity negatively, and clearing the infection produces a small significant rebound, but it is not known whether height and weight in children are impacted over the long term. METHODS We investigated 295 school-age children followed in 2 cohorts, treated (150) and untreated (145), from 2004 for 3.7 years with 1105 child-years of observation. Follow-up intervals were 3 months for anthropometry measurements and 6 months for H. pylori status ascertained by urea breath test. Height in centimeters and weight in kilograms were analyzed using growth models. RESULTS A multivariate mixed model that adjusted for age, sex, father's education, and number of siblings found no significant differences in height or weight at baseline by H. pylori status. The same model showed a significant impact of clearing H. pylori across time, with increasing significant differences in average height and weight as the follow-up progressed. CONCLUSIONS Children who were always negative or who cleared the infection grew significantly faster than those who stayed positive after adjusting for other covariates. This study suggests that school-age children's growth benefits from being treated for H. pylori infection.
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23
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Bohórquez MS, Liévano MC, Campuzano G, Bolívar T, Rozo A. Prevalencia de Helicobacter pylori en escolares: factores nutricionales y socio-culturales en Bogotá. PEDIATRIA-ASUNCION 2012. [DOI: 10.1016/s0120-4912(15)30008-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mera RM, Bravo LE, Goodman KJ, Yepez MC, Correa P. Long-term effects of clearing Helicobacter pylori on growth in school-age children. Pediatr Infect Dis J 2012; 31:263-6. [PMID: 22315005 PMCID: PMC3415984 DOI: 10.1097/inf.0b013e3182443fec] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A new Helicobacter pylori infection affects growth velocity negatively, and clearing the infection produces a small significant rebound, but it is not known whether height and weight in children are impacted over the long term. METHODS We investigated 295 school-age children followed in 2 cohorts, treated (150) and untreated (145), from 2004 for 3.7 years with 1105 child-years of observation. Follow-up intervals were 3 months for anthropometry measurements and 6 months for H. pylori status ascertained by urea breath test. Height in centimeters and weight in kilograms were analyzed using growth models. RESULTS A multivariate mixed model that adjusted for age, sex, father's education, and number of siblings found no significant differences in height or weight at baseline by H. pylori status. The same model showed a significant impact of clearing H. pylori across time, with increasing significant differences in average height and weight as the follow-up progressed. CONCLUSIONS Children who were always negative or who cleared the infection grew significantly faster than those who stayed positive after adjusting for other covariates. This study suggests that school-age children's growth benefits from being treated for H. pylori infection.
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Affiliation(s)
- Robertino M Mera
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA.
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25
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Vendt N, Kool P, Teesalu K, Lillemäe K, Maaroos HI, Oona M. Iron deficiency and Helicobacter pylori infection in children. Acta Paediatr 2011; 100:1239-43. [PMID: 21434997 DOI: 10.1111/j.1651-2227.2011.02281.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM To examine the relationship between iron deficiency (ID) and Helicobacter pylori infection in school-aged children. METHODS Altogether 363 children from ambulatory admission were consecutively enrolled in the study. Haemoglobin (Hb), soluble transferrin receptor (sTfR), IgG against H. pylori and IgA against tissue transglutaminase were measured. The criteria for ID were sTfR > 5.7 mg/L in children aged 7-12 years and sTfR > 4.5 mg/L in older children, for anaemia Hb < 115 g/L in the younger group and Hb < 130 g/L for older boys and Hb < 120 g/L for girls. RESULTS Iron deficiency was found in 17% of the children, 5% had also anaemia. H. pylori colonization was detected in 27% and serum markers for coeliac disease in 0.6% of the children. The prevalence of ID and H. pylori seropositivity was higher in older children (23% and 29%, vs 9% and 22%, respectively). Children with H. pylori were significantly shorter [length SDS 1.0 (0.98-1.01) vs 0.98 (0.97-0.99)]. Older children had risk for ID (OR 1.1, 95% CI 1.0-1.3, p = 0.03). Although the prevalence of H. pylori seropositivity was higher in the ID group, it was not significantly associated with ID in multivariate analysis. CONCLUSION Helicobacter pylori seropositivity was not associated with ID. The associated factor for ID was age.
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Affiliation(s)
- N Vendt
- Anaesthesiology and Intensive Care Clinic, Tartu University Hospital, Tartu, Estonia.
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26
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Abstract
BACKGROUND Helicobacter pylori infection affects about half of the world's population and is usually acquired in childhood. The infection has been associated with chronic gastritis, peptic ulcer, and stomach cancer in adulthood. Little is known, however, about its consequences on child health. We examined the effect of H. pylori infection on growth among school-age children in the Colombian Andes by comparing growth velocity in the presence and absence of H. pylori infection. METHODS Children who were 4-8 years old in 2004 were followed up in a community where infected children received anti-H. pylori treatment (n = 165) and a comparison community (n = 161) for a mean of 2.5 years. Anthropometry measurements were made every 3 months and H. pylori status ascertained by urea breath test every 6 months. Growth velocities (cm/month) were compared across person-time with and without infection, using mixed models for repeated measures. RESULTS In the untreated community, 83% were H. pylori-positive at baseline and 89% were -positive at study end. The corresponding prevalences were 74% and 46%, respectively, in the treated community. Growth velocity in the pretreatment interval was 0.44 (standard deviation [SD] = 0.13) cm/month. Models that adjusted for age, sex, and height estimated that H. pylori-positive children grew on average 0.022 cm/month (95% confidence interval = 0.008 to 0.035) slower than H. pylori-negative children, a result that was not appreciably altered by adjustment for socioenvironmental covariates. CONCLUSIONS This study suggests that chronic H. pylori infection is accompanied by slowed growth in school-age Andean children.
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Effect of Helicobacter pylori infection on growth velocity of school-age Andean children. EPIDEMIOLOGY (CAMBRIDGE, MASS.) 2011. [PMID: 21068668 DOI: 10.1097/ede] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori infection affects about half of the world's population and is usually acquired in childhood. The infection has been associated with chronic gastritis, peptic ulcer, and stomach cancer in adulthood. Little is known, however, about its consequences on child health. We examined the effect of H. pylori infection on growth among school-age children in the Colombian Andes by comparing growth velocity in the presence and absence of H. pylori infection. METHODS Children who were 4-8 years old in 2004 were followed up in a community where infected children received anti-H. pylori treatment (n = 165) and a comparison community (n = 161) for a mean of 2.5 years. Anthropometry measurements were made every 3 months and H. pylori status ascertained by urea breath test every 6 months. Growth velocities (cm/month) were compared across person-time with and without infection, using mixed models for repeated measures. RESULTS In the untreated community, 83% were H. pylori-positive at baseline and 89% were -positive at study end. The corresponding prevalences were 74% and 46%, respectively, in the treated community. Growth velocity in the pretreatment interval was 0.44 (standard deviation [SD] = 0.13) cm/month. Models that adjusted for age, sex, and height estimated that H. pylori-positive children grew on average 0.022 cm/month (95% confidence interval = 0.008 to 0.035) slower than H. pylori-negative children, a result that was not appreciably altered by adjustment for socioenvironmental covariates. CONCLUSIONS This study suggests that chronic H. pylori infection is accompanied by slowed growth in school-age Andean children.
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Abstract
Helicobacter pylori (H. pylori) infection, quite prevalent in the developing countries, is considered to be one of the causative factors for various gastric pathologies and other nongastric diseases. It is believed that H. pylori infection is almost always acquired in early childhood and persists throughout life unless specific treatment is given. The (13/14)C-urea breath test (UBT) is now considered to be a 'gold standard' technique for the detection of H. pylori infection. However, because of the lack of facilities and high cost, the preferred nonradioactive ¹³C-UBT cannot be performed on pediatric patients in developing countries, whereas the radioactive ¹⁴C-UBT is not used on children because of the fear of radiation exposure. When using 37 kBq (1 μCi) of ¹⁴C-urea for the ¹⁴C-UBT, the patient is not exposed to more radiation than is acquired from the natural environment in one day, as almost all the ingested radioactivity is excreted from the body (urine and breath) within 72-120 h. This article reviews the importance of the ¹⁴C-UBT for the detection of H. pylori and justifies the radiation safety aspects of its use in children without any fear of 'radiation phobia' where the facility for ¹³C-UBT is lacking.
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Hussey S, Jones NL. Helicobacter pylori in Childhood. PEDIATRIC GASTROINTESTINAL AND LIVER DISEASE 2011:293-308.e10. [DOI: 10.1016/b978-1-4377-0774-8.10028-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Pacifico L, Anania C, Osborn JF, Ferraro F, Chiesa C. Consequences of Helicobacter pylori infection in children. World J Gastroenterol 2010; 16:5181-94. [PMID: 21049552 PMCID: PMC2975089 DOI: 10.3748/wjg.v16.i41.5181] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 06/21/2010] [Accepted: 06/28/2010] [Indexed: 02/06/2023] Open
Abstract
Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent abdominal pain, chronic idiopathic thrombocytopenia, and poor growth. There is evidence of the role of H. pylori in childhood iron deficiency anemia, but the results are not conclusive. The possibility of an inverse relationship between H. pylori and gastroesophageal reflux disease, as well as childhood asthma, remains a controversial question. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae.
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Gulcan M, Ozen A, Karatepe HO, Gulcu D, Vitrinel A. Impact of H. pylori on growth: is the infection or mucosal disease related to growth impairment? Dig Dis Sci 2010; 55:2878-86. [PMID: 20112067 DOI: 10.1007/s10620-009-1091-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 12/03/2009] [Indexed: 12/17/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has been recognized as one of the most common chronic bacterial infections in the world. Most children are colonized in early childhood, and the infection will last a lifetime unless the child is treated with appropriate antibiotics. AIM To evaluate whether H. pylori infection has an influence on growth and whether the severity of endoscopic findings relates to the growth impairment. METHODS We formed four groups based on the presence or absence of H. pylori infection and gastrointestinal complaints as follows: group I: RAP +/H. pylori+; group II: RAP +/H. pylori-; group III: RAP -/H. pylori+; group IV: RAP -/H. pylori-. The relationship between endoscopic appearances, histological severity of gastritis, and antral H. pylori density with growth parameters was evaluated. RESULTS The BMI standard derivation scores of groups I and II were significantly lower than those of asymptomatic controls independent of their H. pylori status. A significant difference in height for age standard derivation scores was observed only between groups I and IV. When we compared the BMI and height for age standard derivation scores of group III and group IV combined with that of the endoscopically normal children in the recurrent abdominal pain group, there was no significant difference between the two groups. CONCLUSION Recurrent abdominal pain associated with gastric mucosal injury plays a role in a decrease in BMI independent of H. pylori infection. However, if recurrent abdominal pain originates from H. pylori infection, it appears that linear growth is also affected.
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Affiliation(s)
- Mahir Gulcan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Yeditepe University Medical Faculty, Istanbul, Turkey
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Atherton JC, Blaser MJ. Coadaptation of Helicobacter pylori and humans: ancient history, modern implications. J Clin Invest 2009. [PMID: 19729845 DOI: 10.1172/jci38605.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Humans have been colonized by Helicobacter pylori for at least 50,000 years and probably throughout their evolution. H. pylori has adapted to humans, colonizing children and persisting throughout life. Most strains possess factors that subtly modulate the host environment, increasing the risk of peptic ulceration, gastric adenocarcinoma, and possibly other diseases. H. pylori genes encoding these and other factors rapidly evolve through mutation and recombination, changing the bacteria-host interaction. Although immune and physiologic responses to H. pylori also contribute to pathogenesis, humans have evolved in concert with the bacterium, and its recent absence throughout the life of many individuals has led to new human physiological changes. These may have contributed to recent increases in esophageal adenocarcinoma and, more speculatively, other modern diseases.
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Affiliation(s)
- John C Atherton
- Nottingham Digestive Diseases Centre Biomedical Research Unit and Institute of Infection, Immunity and Inflammation, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, United Kingdom.
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Atherton JC, Blaser MJ. Coadaptation of Helicobacter pylori and humans: ancient history, modern implications. J Clin Invest 2009; 119:2475-87. [PMID: 19729845 DOI: 10.1172/jci38605] [Citation(s) in RCA: 378] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Humans have been colonized by Helicobacter pylori for at least 50,000 years and probably throughout their evolution. H. pylori has adapted to humans, colonizing children and persisting throughout life. Most strains possess factors that subtly modulate the host environment, increasing the risk of peptic ulceration, gastric adenocarcinoma, and possibly other diseases. H. pylori genes encoding these and other factors rapidly evolve through mutation and recombination, changing the bacteria-host interaction. Although immune and physiologic responses to H. pylori also contribute to pathogenesis, humans have evolved in concert with the bacterium, and its recent absence throughout the life of many individuals has led to new human physiological changes. These may have contributed to recent increases in esophageal adenocarcinoma and, more speculatively, other modern diseases.
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Affiliation(s)
- John C Atherton
- Nottingham Digestive Diseases Centre Biomedical Research Unit and Institute of Infection, Immunity and Inflammation, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, United Kingdom.
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Ferrara M, Capozzi L, Russo R. Influence of Helicobacter pylori infection associated with iron deficiency anaemia on growth in pre-adolescent children. ACTA ACUST UNITED AC 2009; 14:173-6. [PMID: 19490764 DOI: 10.1179/102453309x402287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In 102 children of both genders aged between 10 and 12 years affected by iron deficiency anaemia (IDA) from various causes, a retrospective study from 1999 to 2007 has been performed to investigate possible relationships between IDA and physical growth. Patients were divided into two groups according to gender. Hb, MCV, ferritin levels, HSDS and body mass index (BMI) were recorded to confirm the diagnosis and the height standard deviation scores were also evaluated. The causes of IDA were investigated. At study entry, both groups of patients, regardless of IDA etiology, had microcytic hypochromic anaemia with low ferritin level. Anthropometric parameters were also reduced. Significant differences of anthropometric parameters were found in both groups in relationship to various causes of IDA (p<0.05) (ANOVA). We conclude that IDA may influence physical growth and etiological factors play an important role on growth delay.
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Affiliation(s)
- M Ferrara
- Department of Pediatrics, The 2nd University of Naples, Naples, Italy.
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Soylu OB, Ozturk Y. Helicobacter pylori infection: effect on malnutrition and growth failure in dyspeptic children. Eur J Pediatr 2008; 167:557-62. [PMID: 17618457 DOI: 10.1007/s00431-007-0552-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 05/25/2007] [Accepted: 06/09/2007] [Indexed: 12/13/2022]
Abstract
There are conflicting reports regarding the association of Helicobacter pylori (H. pylori) infection with growth failure. We evaluated the role of H. pylori infection on malnutrition and growth failure in dyspeptic children. The study cases included 108 dyspeptic children and were evaluated by endoscopic gastric biopsy, while 50 healthy children constituted the control group. The study cases were grouped as H. pylori [+] (n = 57) and H. pylori [-] (n = 51) by the presence or absence of microorganism in gastric tissue, respectively. Age, gender, height for age (H/A), weight for height (W/H), body mass index (BMI), weight and height z scores and the daily calorie intake of the children were recorded. Malnutrition and growth failure were evaluated by the Waterlow criteria and height z score, respectively. Then, the H. pylori [+], H. pylori [-] and control groups were compared in relation to the variables defined above. All groups were similar with respect to gender and age. The daily calorie intake was lower in dyspeptic children. Although anthropometric variables were similar in the H. pylori [+] and [-] groups, the control cases had higher W/H compared to both H. pylori [+] (p = 0.030) and H. pylori [-] (p = 0.000) cases, and higher BMI (p = 0.001) and weight z scores (p = 0.014) than those in the H. pylori [-] group. The malnutrition rate was similar in the H. pylori [+] and [-] groups. However, mild acute (p = 0.033) and general malnutrition rates (p = 0.000) were lower in the control cases compared to the study cases. The short stature rate was not different significantly in all three groups. In conclusion, the results of this study do not support the data that H. pylori infection plays an extra role in malnutrition and growth failure in children presenting with dyspeptic complaints. However, as a major cause of dyspepsia, H. pylori infection might be considered to cause malnutrition secondary to decreased calorie intake associated with dyspepsia.
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Affiliation(s)
- Ozlem Bekem Soylu
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Dokuz Eylul University Medical Faculty, Camliçay Mahallesi, 5182 sokak, No: 12/A, Urla, 35700 Izmir, Turkey.
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Süoglu OD, Gökçe S, Saglam AT, Sökücü S, Saner G. Association of Helicobacter pylori infection with gastroduodenal disease, epidemiologic factors and iron-deficiency anemia in Turkish children undergoing endoscopy, and impact on growth. Pediatr Int 2007; 49:858-63. [PMID: 18045286 DOI: 10.1111/j.1442-200x.2007.02444.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The purpose of the present paper was to investigate the relationship between Helicobacter pylori infection and clinical symptomatology, breast-feeding and socioeconomic level. The relationship between H. pylori and iron-deficiency anemia (IDA) and the effect of H. pylori infection on growth were also investigated. METHODS The subjects consisted of 70 patients aged 4-16 years who underwent upper gastrointestinal endoscopy for recurrent abdominal pain, nausea, vomiting, and dyspeptic complaints during a 2 year period. Patients were divided into two groups according to presence of histological evidence of H. pylori infection (group 1, H. pylori positive; group 2, H. pylori negative) and groups were compared with respect to epidemiologic characteristics, gastrointestinal complaints, height and weight SD scores and IDA. RESULTS Thirty-five (50%) of the 70 patients participating in the study were H. pylori positive. The mean age of group 1 was significantly higher than that of group 2. There were similar characteristics and symptomatology between groups. The majority of the patients in group 1 belonged to low socioeconomic class (class I and II; P < 0.05). The number of the patients exclusively breast-fed for > or =4 months was significantly higher in group 2 than in group 1. Gastritis was significantly more frequent in group 1. Mean hemoglobin, serum Fe and ferritin levels were 11.6 +/- 1.7 g/dL, 45.0 +/- 23.2 microg/dL and 11.9 +/- 8.4 microg/dL, respectively, for group 1 and 12.2 +/- 0.7 g/dL, 79.3 +/- 26.4 microg/dL and 42.1 +/- 31.8 microg/dL, respectively, for group 2. The mean serum Fe and ferritin levels of group 2 were significantly higher than those of group 1. IDA was observed in 20 (57.1%) and six (17.1%) patients in groups 1 and 2, respectively. IDA was significantly more frequent in group 1. Helicobacter pylori infection was found to be the only variable that had significant effect on IDA. Mean SD height and weight for group 1 were lower than those of the group 2. When the patients were evaluated in four groups according to H. pylori and IDA status, mean height SD score of patients with both H. pylori infection and IDA was significantly lower than that of the patients negative for H. pylori and IDA concomitantly. CONCLUSION Low socioeconomic status seems to be an important risk factor for H. pylori infection. Exclusive breast-feeding at least for 4 months can have a protective role against H. pylori infection. Increased frequency of growth retardation and IDA in H. pylori-infected patients in the present study supports similar findings in the literature, although there is still need for detailed studies to clarify the causative mechanisms.
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Affiliation(s)
- Ozlem Durmaz Süoglu
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey.
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Gøbel R, Symonds EL, Butler RN, Tran CD. Association between Helicobacter pylori infection in mothers and birth weight. Dig Dis Sci 2007; 52:3049-53. [PMID: 17410433 DOI: 10.1007/s10620-007-9772-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 01/17/2007] [Indexed: 12/22/2022]
Abstract
Helicobacter pylori infection may cause intrauterine growth restriction (IUGR). However, it is unknown whether the growth of children from H. pylori-infected mothers is also affected or whether transmission of infection from mother to child occurs. This study aimed to determine if maternal H. pylori infection was associated with IUGR and low birth weight in a mouse model, and whether transmission of infection from mother to infant occurs. Female C57BL/6 mice were inoculated with H. pylori (n = 18) or water (control; n = 18) via gavage. Mice were mated at 6 weeks postinfection, with half of the mice sacrificed after 2 weeks of gestation. The remaining mice gave birth and a third of the litter was weighed and sacrificed at birth, during milk feeding (1.5 weeks), and during solid feeding (4 weeks). Stomachs of all mice and whole foetuses were cultured for the presence of H. pylori. There were no differences in litter size or foetus weight between control and H. pylori-infected mice. Pups from infected mothers had a lower weight during milk feeding (control, 5.91 +/- 0.23 g; H. pylori, 4.59 +/- 0.16 g; p < 0.05) and solid feeding (control, 12.73 +/- 0.58 g; H. pylori, 10.01 +/- 1.02 g; p < 0.05). H. pylori was not detected by culture in the pups at any age. H. pylori infection in mothers was associated with a decrease in infant weight during milk feeding and after weaning. Transmission of infection from mother to infant was not detected by culture, suggesting that decreased baby weight may be due to decreased milk supply or altered nutrition from the mother.
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Affiliation(s)
- Rikke Gøbel
- Gastroenterology Unit, Children, Youth and Women's Health Service, 72 King William Road, North Adelaide, 5006 South Australia, Australia
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Mohammad MA, Hussein L, Coward A, Jackson SJ. Prevalence of Helicobacter pylori infection among Egyptian children: impact of social background and effect on growth. Public Health Nutr 2007; 11:230-6. [PMID: 17666124 DOI: 10.1017/s1368980007000481] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The study aim was to assess the prevalence of Helicobacter pylori infection in Egyptian schoolchildren and its effect on growth parameters. DESIGN A cross-sectional population-based study was conducted among 286 schoolchildren (168 boys and 118 girls), with a mean age of 11.04 +/- 0.19 years, to determine the prevalence of H. pylori. The presence of the bacterium was assessed using the [13C]urea breath test. Relevant personal and socio-economic data on risk factors for infection were collected. Height and weight were analysed in relation to H. pylori infection. RESULTS The overall prevalence of H. pylori infection was 72.38%. Attending school in a socially deprived area and residing in an overcrowded home were the major risk factors for infection. Differences between infected and non-infected children were significant with regard to body weight and height (weight: 39.5 +/- 1.0 vs. 44.6 +/- 1.8 kg, P = 0.05; height: 139.9 +/- 1.3 vs. 144.2 +/- 2.1 cm; P = 0.009). The number of children (both boys and girls) falling below the 5th percentile of height-for-age was significantly higher in infected than non-infected children (P = 001), similarly for Z-scores for height-for-age below -2.0 (P = 0.003). CONCLUSION The results demonstrate not only that the prevalence of H. pylori infection is extremely high among Egyptian schoolchildren, but also that the adverse effects of the infection reach far beyond the stomach. Evidence of the burden of infection on growth failure is presented.
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Affiliation(s)
- Mahmoud A Mohammad
- Department of Nutrition, National Research Center, Giza - Dokki 12311, El Bouhous Str, Egypt
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Fialho AMN, Braga ABC, Queiroz DMM, Rodrigues MN, Herbster ID, Braga LLBC. The association between Helicobacter pylori infection and height in children from an urban community in north-east Brazil. ACTA ACUST UNITED AC 2007; 27:55-61. [PMID: 17469733 DOI: 10.1179/146532807x170510] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND An association between Helicobacter pylori infection and short stature in children has been described recently. AIM To describe differences in stature between H. pylori-infected and non-infected children in a low-income community in north-east Brazil. METHODS H. pylori status was evaluated by 13C-urea-breath test; centile values for weight and height were calculated for each child. RESULTS The prevalence of H. pyloni was 55.8% (197/353) and increased with age. Of 197 H. pylori-positive children, 62% were below the 25th centile for height compared with 48% of H. pylori-negative children (75/156) [AOR (adjusted odds ratio) 1.61, 95% CI 1.04-2.49, p=0.03] after adjustment for variables with p < 0.25 in univariate analysis (gender, number of residents, of children per household and of persons per bed). These results were significant only when older children were included. Thus, in children aged 8-14 years, 80% (89/111) of H. pylori-positive were <25th centile for height compared with 63% (35/56) of H. pylori-negative children (p=0.01). Compared with children with a height >25th centile, the AOR for H. pylori infection increased from 2.42 in the crude analysis to 6.62 after adjustment (p=0.006). CONCLUSIONS H. pylori is associated with short stature in older children living in a poor urban community in Brazil.
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Affiliation(s)
- André M N Fialho
- Clinical Research Unit, University Hospital Walter Cantideo/Department of Internal Medicine, Ceará Federal University, Brazil
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Ozdem S, Akcam M, Yilmaz A, Gultekin M, Artan R. Biochemical markers of bone metabolism in children with Helicobacter pylori infection. Dig Dis Sci 2007; 52:967-72. [PMID: 17318389 DOI: 10.1007/s10620-006-9292-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 03/02/2006] [Indexed: 12/23/2022]
Abstract
We investigated the biochemical markers of bone metabolism in children with Helicobacter pylori infection. Biochemical markers of bone metabolism and serum levels of vitamin B12, ferritin and estradiol were measured in 41 H. pylori-positive (+) children (23 girls, 18 boys; aged 11.8+/-3 years). Serum levels of intact parathyroid hormone, ss-collagen I carboxy terminal telopeptide, total alkaline phosphatase (ALP), bone-specific ALP, N-terminal cross-links of human procollagen type I, N-mid-osteocalcin, calcium, phosphate, ferritin, and estradiol did not differ significantly between H. pylori(+) and H. pylori negative (-) children. Vitamin B12 levels were significantly decreased in H. pylori(+) compared to H. pylori(-) children. H. pylori infection was not accompanied by significant changes in markers of bone metabolism in children, although vitamin B12 levels were decreased. Further studies are required to clarify whether H. pylori infection causes time-dependent changes in bone turnover markers during the long course of this inflammatory disease.
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Affiliation(s)
- Sebahat Ozdem
- Central Laboratory, Clinical Biochemistry Unit, Akdeniz University, Medical Faculty, 07070 Antalya, Turkey.
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Ozdem S, Akcam M, Yilmaz A, Artan R. Insulin resistance in children with Helicobacter pylori infection. J Endocrinol Invest 2007; 30:236-40. [PMID: 17505158 DOI: 10.1007/bf03347431] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We aimed at investigating insulin resistance in children with Helicobacter pylori (H. pylori) infection. Fasting serum insulin and glucose levels were determined in 31 children with H. pylori (+) (H. pylori-infected group, 20 girls and 11 boys, median age 12 yr, range 6-17) and 29 H. pylori (-) (control group, 18 girls and 11 boys, median age 13 yr, range 5-16). Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) score. Fasting serum glucose levels did not differ significantly between H. pylori (+) and (-) children. Both HOMA-IR score and serum insulin levels were significantly higher in H. pylori-infected compared to control children. The findings of the present study suggested that there is a certain relation between H. pylori infection and insulin resistance in children.
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Affiliation(s)
- S Ozdem
- Central Laboratory Clinical Biochemistry Unit, Medical Faculty, Akdeniz University, Antalya, Turkey.
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Chimonas MAR, Baggett HC, Parkinson AJ, Muth PT, Dunaway E, Gessner BD. Asymptomatic Helicobacter pylori infection and iron deficiency are not associated with decreased growth among Alaska Native children aged 7-11 years. Helicobacter 2006; 11:159-67. [PMID: 16684263 DOI: 10.1111/j.1523-5378.2006.00395.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Alaska Native children have high Helicobacter pylori infection and iron deficiency prevalences, and their average height-for-age is lower than US reference populations. During a clinical trial to determine the impact of H. pylori treatment on iron deficiency, we evaluated the effects of H. pylori infection and treatment on growth. MATERIALS AND METHODS We measured height and weight for children aged 7-11 years in western Alaska using village-based measuring devices. H. pylori infection was determined by urea breath test and iron deficiency using serum ferritin. Children with H. pylori infection and iron deficiency entered the treatment phase and received iron alone or iron plus triple therapy for H. pylori. Follow-up evaluations occurred at 2, 8, and 14 months. We evaluated the association between baseline H. pylori infection and growth; among children in the treatment phase, we also assessed the effect of H. pylori resolution on growth. RESULTS At baseline, 566 (87.1%) of 650 children were infected with H. pylori. Neither height and weight, nor body mass index differed by H. pylori infection status. Of 189 children in the treatment phase, 20 (10.6%) were uninfected at all three follow-up periods, and 54 (28.6%) were uninfected for one or two periods. Compared with continuously infected children, children in these two groups had little evidence of improvements in any of the measured growth outcomes. CONCLUSIONS H. pylori infection is not related to growth among Alaska Native children aged 7-11 years. Growth deficiency should not be considered an indication for H. pylori therapy.
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Affiliation(s)
- Marc-Andre R Chimonas
- US Centers for Disease Control and Prevention, Office of Workforce and Career Development, Epidemic Intelligence Service Officer, Alaska Division of Public Health, Anchorage, Alaska 99524, USA
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Eslick GD. Helicobacter pylori infection causes gastric cancer? A review of the epidemiological, meta-analytic, and experimental evidence. World J Gastroenterol 2006; 12:2991-9. [PMID: 16718777 PMCID: PMC4124371 DOI: 10.3748/wjg.v12.i19.2991] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Revised: 01/08/2006] [Accepted: 01/14/2006] [Indexed: 02/06/2023] Open
Abstract
Since the discovery of Campylobacter-like organisms Helicobacter pylori (H pylori) more than two decades ago the possibility of a relationship with gastric cancer has been postulated, tested and supposedly proven. There have been numerous human studies of various designs from many countries around the world. Several meta-analyses have been published and more recently a small number of experimental animal studies were reported looking at the association between H pylori infection and gastric cancer. Over the years, the human epidemiological studies have produced conflicting results; the meta-analyses have as one would expect produced similar pooled estimates; while the early experimental animal studies require replication. The exact mechanisms by which H pylori might cause gastric cancer are still under investigation and remain to be elucidated.
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Affiliation(s)
- Guy-D Eslick
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
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Leandro Liberato SV, Hernández Galindo M, Torroba Alvarez L, Sánchez Miramón F, Leandro Ciriza SE, Gómez Abadía A, Chueca Rodríguez P. [Helicobacter pylori infection in the child population in Spain: prevalence, related factors and influence on growth]. An Pediatr (Barc) 2006; 63:489-94. [PMID: 16324613 DOI: 10.1016/s1695-4033(05)70247-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION A causal relationship between Helicobacter pylori infection and the occurrence of digestive diseases in adults and children has been proven. Worldwide, the prevalence of H. pylori varies and it is possibly influenced by differences in the level of development. The goals of this study were a) to ascertain the prevalence of H. pylori infection in the child population in Spain, b) to study several factors related to this infection, and c) to establish its possible influence on growth. PATIENTS AND METHODS We performed a descriptive, cross-sectional survey of a representative sample of children aged 1 to 14 years old. The sample consisted of 284 children (prevalence 5 15 %; accuracy 5 4 %; CI > 95 %), selected at random and stratified by age and sex. A pre-coded questionnaire was used for data collection. Diagnosis of H. pylori was established by detection of H. pylori antigen in stools with enzyme immunoassay. RESULTS The sample consisted of 144 boys and 140 girls, with a mean age of 6.89 6 4.25 years. The prevalence of H. pylori infection was 15.8 % and progressively increased with age: 1- to 3-year-olds (8.4 %), 4- to 9-year-olds (13.9 %), 10- to 14-year-olds (24 %) (p < 0.05). The prevalence was significantly higher in boys (p < 0.01). Analysis of socio-environmental variables showed a higher H. pylori infection rate in children from families with a low socioeconomic level (p < 0.01), a high rate of overcrowding (p < 0.05), and in immigrants (p < 0.001). The H. pylori infection rate was higher in children with recurrent abdominal pain (p < 0.001) and in those whose parents had suffered from gastroduodenal disease (p < 0.001). H. pylori infection was more frequent in children aged 10 to 14 years old with weight and height percentiles below the 25th percentile (p < 0.05). Comparison of means revealed no significant differences. CONCLUSIONS The prevalence of H. pylori infection found in our study was slightly lower than that found in other studies carried out in Spain; our data were more similar to those of industrialized countries. H. pylori infection was linked to age, sex and deprived socioeconomic environments, and was more frequent in children with recurrent abdominal pain and in those whose parents suffered from gastroduodenal disease. H. pylori infection did not seem to negatively affect growth in our child population.
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Sood MR, Joshi S, Akobeng AK, Mitchell J, Thomas AG. Growth in children with Helicobacter pylori infection and dyspepsia. Arch Dis Child 2005; 90:1025-8. [PMID: 15956048 PMCID: PMC1720122 DOI: 10.1136/adc.2004.066803] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS To compare the height, weight, and body mass index (BMI) of children presenting with dyspeptic symptoms and Helicobacter pylori infection, to those with dyspepsia but without the infection. METHODS A retrospective chart review of 257 children was performed. 13C urea breath test was performed to detect H pylori infection; weight and height were recorded and BMI was calculated. Weight, height, and BMI SD scores were determined using the 1990 UK normative data. The Index of Multiple Deprivation 2004 (IMD 2004) scores, which measure deprivation at small area level, were calculated from the patients' postcodes. RESULTS Ninety seven of the 257 children were H pylori positive. The mean age at diagnosis and presenting symptoms of H pylori positive and negative patients were similar. The mean IMD 2004 scores for children with H pylori infection were significantly higher compared to H pylori negative patients, suggesting that children with the infection came from relatively more deprived areas. The mean weight and height SD score were significantly lower for children with H pylori infection compared to those without. However, this difference was no longer significant after adjusting for socioeconomic deprivation and ethnic differences between the groups. CONCLUSION Children with dyspepsia and H pylori infection were shorter and lighter than patients with similar symptoms but no infection. The differences in anthropometry may be due to socioeconomic and ethnic factors rather than H pylori infection.
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Affiliation(s)
- M R Sood
- Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Abstract
This article focuses on the five most common bacterial enteropathogens of the developed world--Helicobacter pylori, Escherichia coli, Shigella, Salmonella, and Campylobacter--from the perspective of how they cause disease and how they relate to each other. Basic and recurring themes of bacterial pathogenesis, including mechanisms of entry, methods of adherence, sites of cellular injury, role of toxins, and how pathogens acquire particular virulence traits (and antimicrobial resistance), are discussed.
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Affiliation(s)
- Manuel R Amieva
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, CA 94305-5208, USA.
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Camargo MC, Yepez MC, Ceron C, Guerrero N, Bravo LE, Correa P, Fontham ETH. Age at acquisition of Helicobacter pylori infection: comparison of two areas with contrasting risk of gastric cancer. Helicobacter 2004; 9:262-70. [PMID: 15165263 DOI: 10.1111/j.1083-4389.2004.00221.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Helicobacter pylori infection is usually acquired during childhood and is a known risk factor for the development of gastric malignancies in adulthood. It has been reported that early age at first infection may determine a neoplastic outcome in adults. The purpose of this study was to determine the prevalence of Helicobacter pylori infection in children residing in areas with high (Pasto) and low risk (Tumaco) of gastric cancer in Colombia to evaluate whether differences in the age of acquisition of H. pylori infection were present in the two populations. MATERIALS AND METHODS The study sample was based on a census taken in 1999. Using the (13)C-urea breath test, we compared the prevalence of H. pylori infection among children aged 1-6 years. RESULTS Among 345 children in Pasto, 206 (59.7%) were H. pylori-positive, compared with 188 (58.6%) among 321 children in Tumaco. The two populations share a common pattern of very early age at infection and marked increase in prevalence during the first 4 years of life. No differences in any one year were observed when comparing the two groups. CONCLUSIONS The prevalence of infection was similarly high and increased with age in both populations. In these populations the age of acquisition of H. pylori after 1 year of age does not appear to be a primary factor responsible for the differences in the rates of gastric cancer incidence in adults. Previous findings in adults showed lower prevalence of the most virulent genotypes in Tumaco compared to Pasto, and bacterial virulence may play a key role in determining cancer outcome.
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Affiliation(s)
- M Constanza Camargo
- Department of Pathology, Louisiana State University Health Science Center, New Orleans 70112, USA
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Inui A, Asakawa A, Bowers CY, Mantovani G, Laviano A, Meguid MM, Fujimiya M. Ghrelin, appetite, and gastric motility: the emerging role of the stomach as an endocrine organ. FASEB J 2004; 18:439-56. [PMID: 15003990 DOI: 10.1096/fj.03-0641rev] [Citation(s) in RCA: 264] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent progress in the field of energy homeostasis was triggered by the discovery of adipocyte hormone leptin and revealed a complex regulatory neuroendocrine network. A late addition is the novel stomach hormone ghrelin, which is an endogenous agonist at the growth hormone secretagogne receptor and is the motilin-related family of regulatory peptides. In addition to its ability to stimulate GH secretion and gastric motility, ghrelin stimulates appetite and induces a positive energy balance leading to body weight gain. Leptin and ghrelin are complementary, yet antagonistic, signals reflecting acute and chronic changes in energy balance, the effects of which are mediated by hypothalamic neuropeptides such as neuropeptide Y and agouti-related peptide. Endocrine and vagal afferent pathways are involved in these actions of ghrelin and leptin. Ghrelin is a novel neuroendocrine signal possessing a wide spectrum of biological activities that illustrates the importance of the stomach in providing input into the brain. Defective ghrelin signaling from the stomach could contribute to abnormalities in energy balance, growth, and associated gastrointestinal and neuroendocrine functions.
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Affiliation(s)
- Akio Inui
- Division of Diabetes, Digestive and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
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Camargo MC, Constanza CM, Lazcano-Ponce E, Eduardo LP, Torres J, Javier T, Velasco-Mondragon E, Eduardo VM, Quiterio M, Manuel Q, Correa P, Pelayo C. Determinants of Helicobacter pylori seroprevalence in Mexican adolescents. Helicobacter 2004; 9:106-14. [PMID: 15068411 DOI: 10.1111/j.1083-4389.2004.00206.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Helicobacter pylori infection is one of the most common human infections and is considered to play an etiologic role in several gastroduodenal diseases. In this study we determined the H. pylori seroprevalence among adolescents in Morelos, Mexico, and explored the association between seroprevalence and socioeconomic, dietary and lifestyle variables. MATERIALS AND METHODS A cross-sectional study was conducted in 5861 Mexican subjects aged 11-21 years. H. pylori infection was determined by an enzyme-linked immunosorbent assay previously validated in Mexico. A self-administered questionnaire was used to collect information on sociodemographic factors, housing, living conditions and food consumption. Multivariate logistic regression methods were used to obtain odds ratios and 95% confidence intervals. RESULTS The overall H. pylori seroprevalence was 47.6%; 40.6% in preadolescents (11-14 years), 48.6% in adolescents (15-17 years), and 59.8% in young adults (18-24 years). A positive association was found between age and H. pylori seroprevalence. Inverse associations were found for availability of drinking water, sewerage, and home appliances at the time of the subject's birth, a proxy variable of socioeconomic status. Intake of milk products and total fats was positively associated with infection. CONCLUSIONS This large seroprevalence study showed that H. pylori infection is frequent among adolescents in Mexico. An early acquisition of infection is indirectly suggested. Some variables denoting low socioeconomic status were inversely associated with H. pylori seroprevalence. Associations with intake of milk products and total fats suggest new hypotheses in this field of research.
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Affiliation(s)
- M Constanza Camargo
- Center for Population Health Research, National Institute of Public Health, Cuernauaca, Mexico
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Axon ATR. Personal view: to treat or not to treat? Helicobacter pylori and gastro-oesophageal reflux disease - an alternative hypothesis. Aliment Pharmacol Ther 2004; 19:253-61. [PMID: 14984371 DOI: 10.1111/j.1365-2036.2004.01847.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Helicobacter pylori causes acute on chronic gastritis and is responsible for most peptic ulcers and gastric cancer. However, recent papers have suggested that it may protect against gastro-oesophageal reflux, Barrett's oesophagus and oesophageal cancer. Furthermore, the rapid increase in gastro-oesophageal reflux disease, Barrett's oesophagus and adenocarcinoma of the oesophagus in the developed world has been attributed by some to the falling prevalence of H. pylori. These considerations have led to the suggestion that H. pylori infection should not necessarily be treated, especially in patients with gastro-oesophageal reflux disease. Conversely, data from prospective randomized studies have shown that H. pylori eradication does not cause gastro-oesophageal reflux disease in patients with duodenal ulcer or in the normal population, nor does it worsen the outcome of pre-existing gastro-oesophageal reflux disease. Therefore, although H. pylori is negatively associated with gastro-oesophageal reflux disease, its eradication does not induce the disease. A hypothesis is presented suggesting that the increased prevalence of gastro-oesophageal reflux disease is a result of rising acid secretion in the general population, which, in turn, is a consequence of the increased linear height (a predictor of acid secretion). The greater acid secretion could also explain the decline in the prevalence of H. pylori and perhaps account for the inverse relationship between H. pylori and gastro-oesophageal reflux disease. These considerations are explored in discussing whether H. pylori infection should be treated in infected patients presenting with gastro-oesophageal reflux disease.
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Affiliation(s)
- A T R Axon
- Department of Gastroenterology, The General Infirmary at Leeds, Leeds, UK.
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