Department of Family Medicine, Center for Health Promotion and Clinical Research Center, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
J Korean Med Sci. 2010 Feb;25(2):265-71. doi: 10.3346/jkms.2010.25.2.265. Epub 2010 Jan 22.
It has been suggested that Helicobacter pylori eradication may influence production of some peptides in the stomach, which can affect appetite. This hypothesis is controversial. To verify the hypothesis, we conducted this randomized controlled trial using H. pylori infected subjects without any gastrointestinal symptoms. The treatment group received triple H. pylori eradication therapy for 7 days and the control group received no medication. We measured ghrelin, obestatin and the tumor necrosis factor-alpha (TNF-alpha) mRNA levels in endoscopic biopsy specimens and the changes from baseline to follow-up. The plasma active n-octanoyl ghrelin and obestatin levels were measured in both groups. The ghrelin/obestatin ratios in plasma and gastric mRNA expression were calculated at baseline and follow-up. Ghrelin mRNA expression in the fundic mucosa after H. pylori eradication increased significantly compared to the control group (4.47+/-2.14 vs. 1.79+/-0.96, P=0.009), independent of inflammatory changes. However, obestatin mRNA expression decreased in the antral mucosa (-0.57+/-1.06 vs. 0.41+/-0.72, P=0.028). The treatment group showed a marginal increase (P=0.060) in plasma ghrelin/obestatin ratio. The TNF-alpha mRNA expression also decreased significantly with treatment. This randomized controlled trial demonstrates that H. pylori eradication increases ghrelin mRNA expression, independent of inflammatory cell changes.
有人提出，幽门螺杆菌的根除可能会影响胃某些肽类的产生，从而影响食欲。这一假说存在争议。为了验证这一假说，我们对无胃肠道症状的幽门螺杆菌感染患者进行了这项随机对照试验。治疗组接受了为期 7 天的三联幽门螺杆菌根除治疗，而对照组未接受任何药物治疗。我们测量了内镜活检标本中的胃泌素、肥胖抑制素和肿瘤坏死因子-α（TNF-α）mRNA 水平，并测量了从基线到随访的变化。两组均测量了血浆活性 n-辛酰基胃泌素和肥胖抑制素水平。计算了基线和随访时血浆和胃黏膜中胃泌素/肥胖抑制素的比值。与对照组相比，根除幽门螺杆菌后胃底黏膜的胃泌素 mRNA 表达显著增加（4.47+/-2.14 对 1.79+/-0.96，P=0.009），与炎症变化无关。然而，幽门螺杆菌根除后，胃窦黏膜的肥胖抑制素 mRNA 表达下降（-0.57+/-1.06 对 0.41+/-0.72，P=0.028）。治疗组的血浆胃泌素/肥胖抑制素比值略有增加（P=0.060）。TNF-αmRNA 表达也随治疗而显著下降。这项随机对照试验表明，幽门螺杆菌的根除可增加胃泌素 mRNA 表达，与炎症细胞变化无关。
