Soylu Ozlem Bekem, Ozturk Yesim
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.
Eur J Pediatr. 2008 May;167(5):557-62. doi: 10.1007/s00431-007-0552-6. Epub 2007 Jul 6.
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.
关于幽门螺杆菌（H. pylori）感染与生长发育迟缓之间的关联，存在相互矛盾的报道。我们评估了幽门螺杆菌感染在消化不良儿童营养不良和生长发育迟缓中的作用。研究病例包括108名消化不良儿童，通过内镜下胃活检进行评估，同时50名健康儿童组成对照组。研究病例根据胃组织中是否存在微生物分为幽门螺杆菌阳性组（n = 57）和幽门螺杆菌阴性组（n = 51）。记录了儿童的年龄、性别、年龄别身高（H/A）、身高别体重（W/H）、体重指数（BMI）、体重和身高z评分以及每日热量摄入。分别根据沃特洛标准和身高z评分评估营养不良和生长发育迟缓情况。然后，比较幽门螺杆菌阳性组、幽门螺杆菌阴性组和对照组在上述定义变量方面的情况。所有组在性别和年龄方面相似。消化不良儿童的每日热量摄入较低。虽然幽门螺杆菌阳性组和阴性组的人体测量变量相似，但对照组的W/H高于幽门螺杆菌阳性组（p = 0.030）和幽门螺杆菌阴性组（p = 0.000），且BMI（p = 0.001）和体重z评分（p = 0.014）高于幽门螺杆菌阴性组。幽门螺杆菌阳性组和阴性组的营养不良率相似。然而，与研究病例相比，对照组的轻度急性营养不良率（p = 0.033）和总体营养不良率（p = 0.000）较低。三组的身材矮小率无显著差异。总之，本研究结果不支持幽门螺杆菌感染在有消化不良症状的儿童营养不良和生长发育迟缓中起额外作用的数据。然而，作为消化不良的主要原因，幽门螺杆菌感染可能被认为是由于消化不良相关的热量摄入减少继发导致营养不良。
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