Roper Jatin, Francois Fritz, Shue Peter L, Mourad Michelle S, Pei Zhiheng, Olivares de Perez Asalia Z, Perez-Perez Guillermo I, Tseng Chi-Hong, Blaser Martin J
New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
J Clin Endocrinol Metab. 2008 Jun;93(6):2350-7. doi: 10.1210/jc.2007-2057. Epub 2008 Apr 8.
Leptin and ghrelin, hormones involved in human energy homeostasis, are both produced in the stomach.
We sought to determine whether the presence of Helicobacter pylori affects gastric and systemic levels of leptin and ghrelin.
DESIGN, SETTING, AND PATIENTS: We consecutively enrolled 256 patients referred for upper endoscopy at a Veterans Affairs outpatient endoscopy center.
We obtained fasting serum, fundic and antral biopsies, and gastric juice. Based on histological, biochemical, and serological assays, patients were categorized as H. pylori+ or H. pylori-. Leptin and total ghrelin levels in serum, gastric biopsies, and gastric juice were determined by specific ELISAs.
Of the 256 subjects, 120 were H. pylori+ and 96 were H. pylori-; 40 patients of indeterminate status were excluded. Serum and fundic leptin levels correlated with body mass index in the H. pylori+ (r = 0.35; P < 0.0001 and r = 0.35; P < 0.0001, respectively) and H. pylori- (r = 0.65; P < 0.0001 and r = 0.41; P < 0.0001, respectively) groups, but H. pylori+ subjects had significantly lower serum leptin levels [median 2.2 ng/ml (interquartile range 0.9-4.6) vs. 4.0 ng/ml (1.7-7.2); P = 0.0003]. Serum ghrelin levels were similar in the H. pylori+ and H. pylori- groups [median 1651 pg/ml (interquartile range 845-2247) vs. 1629 pg/ml (992-2886); P = 0.23]. H. pylori status did not significantly affect gastric biopsy leptin and ghrelin levels. Ghrelin levels in gastric juice varied over 4 log(10) (<80-776,000 pg/ml) and correlated with gastric juice pH in the H. pylori+ group (r = 0.68; P < 0.0001).
These findings provide evidence that H. pylori status affects leptin and ghrelin homeostasis, presumably via intragastric interactions.
瘦素和胃饥饿素是参与人体能量平衡的激素，均由胃产生。
我们试图确定幽门螺杆菌的存在是否会影响瘦素和胃饥饿素的胃内水平及全身水平。
设计、场所和患者：我们在一家退伍军人事务门诊内镜中心连续招募了256例接受上消化道内镜检查的患者。
我们获取了空腹血清、胃底和胃窦活检组织以及胃液。根据组织学、生化和血清学检测，将患者分为幽门螺杆菌阳性（Hp+）或幽门螺杆菌阴性（Hp-）。通过特异性酶联免疫吸附测定法（ELISA）测定血清、胃活检组织和胃液中的瘦素和总胃饥饿素水平。
在256名受试者中，120例为Hp+，96例为Hp-；40例状态不确定的患者被排除。在Hp+组（分别为r = 0.35；P < 0.0001和r = 0.35；P < 0.0001）和Hp-组（分别为r = 0.65；P < 0.0001和r = 0.41；P < 0.0001）中，血清和胃底瘦素水平均与体重指数相关，但Hp+受试者的血清瘦素水平显著较低[中位数2.2 ng/ml（四分位间距0.9 - 4.6）vs. 4.0 ng/ml（1.7 - 7.2）；P = 0.0003]。Hp+组和Hp-组的血清胃饥饿素水平相似[中位数1651 pg/ml（四分位间距845 - 2247）vs. 1629 pg/ml（992 - 2886）；P = 0.23]。幽门螺杆菌状态对胃活检组织中的瘦素和胃饥饿素水平无显著影响。胃液中的胃饥饿素水平在4个对数单位（<80 - 776,000 pg/ml）范围内变化，并与Hp+组的胃液pH值相关（r = 0.68；P < 0.0001）。
这些发现提供了证据，表明幽门螺杆菌状态可能通过胃内相互作用影响瘦素和胃饥饿素的稳态。
