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World J Gastroenterol. Sep 28, 2014; 20(36): 12809-12817
Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.12809
Role of Helicobacter pylori infection on nutrition and metabolism
Francesco Franceschi, Annalisa Tortora, Teresa Di Rienzo, Giovanna D’Angelo, Gianluca Ianiro, Franco Scaldaferri, Viviana Gerardi, Valentina Tesori, Loris Riccardo Lopetuso, Antonio Gasbarrini
Francesco Franceschi, Department of Emergency, Internal Medicine Institute, Catholic University of Sacred Heart, 00168 Rome, Italy
Annalisa Tortora, Teresa Di Rienzo, Giovanna D’Angelo, Gianluca Ianiro, Franco Scaldaferri, Viviana Gerardi, Valentina Tesori, Loris Riccardo Lopetuso, Antonio Gasbarrini, Department of Medicine, Internal Medicine and Gastroenterology, Catholic University of Sacred Heart, 00168 Rome, Italy
Author contributions: All authors had contributed to the realization of this manuscript; Francesco F and Tortora A contributed to writing it; D’Angelo G, Ianiro G and Scaldaferri F contributed to performing PubMed search of articles published on nutrition; Gerardi V, Tesori V and Lopetuso LR contributed to performing PubMed search of articles published on metabolism; and Gasbarrini A contributed to editing the final version.
Correspondence to: Francesco Franceschi, MD, Professor, Department of Emergency, Internal Medicine Institute, Catholic University of Sacred Heart, Largo A. Gemelli, 8, 00168 Rome, Italy. francesco.franceschi@rm.unicatt.it
Telephone: +39-6-30157271 Fax: +39-6-35502775
Received: January 16, 2014
Revised: March 12, 2014
Accepted: May 23, 2014
Published online: September 28, 2014
Processing time: 257 Days and 23.7 Hours
Abstract

Helicobacter pylori (H. pylori) is a gram-negative pathogen that is widespread all over the world, infecting more than 50% of the world’s population. It is etiologically associated with non-atrophic and atrophic gastritis, peptic ulcer and shows a deep association with primary gastric B-cell lymphoma and gastric adenocarcinoma. Recently, the medical research focused on the modification of the gastric environment induced by H. pylori infection, possibly affecting the absorption of nutrients and drugs as well as the production of hormones strongly implicated in the regulation of appetite and growth. Interestingly, the absorption of iron and vitamin B12 is impaired by H. pylori infection, while infected subjects have lower basal and fasting serum levels of ghrelin and higher concentration of leptin compared to controls. Since leptin is an anorexigenic hormone, and ghrelin stimulates powerfully the release of growth hormone in humans, H. pylori infection may finally induce growth retardation if acquired very early in the childhood and in malnourished children. This review is focused on the nutritional effects of H. pylori infection, such as the reduced bioavailability or the malabsorbption of essential nutrients, and of gastrointestinal hormones, as well as on the relationship between H. pylori and the metabolic syndrome.

Keywords: Helicobacter pylori; Malabsorption; Metabolic syndrome; Gastrointestinal hormones

Core tip: This review analyzes in a very comprehensive way all aspects related to nutrition and metabolism induced by Helicobacter pylori (H. pylori). Interestingly, this bacterium is able to produce different biological effects on hormones controlling both appetite and growth, mostly depending on the time of acquisition of the infection and of eradication. On the other hand, H. pylori is able to induce malabsorption of several nutrients, with a strong effect on nutrition.