Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Epidemiology. 2011 Jan;22(1):118-26. doi: 10.1097/EDE.0b013e3181fe7e31.
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.
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.
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.
This study suggests that chronic H. pylori infection is accompanied by slowed growth in school-age Andean children.
幽门螺杆菌感染影响了世界上约一半的人口，通常在儿童时期获得。该感染与成年人的慢性胃炎、消化性溃疡和胃癌有关。然而，人们对其对儿童健康的影响知之甚少。我们通过比较有和没有幽门螺杆菌感染的情况下的生长速度，来研究幽门螺杆菌感染对哥伦比亚安第斯地区学龄儿童生长的影响。
2004 年，4-8 岁的儿童在一个社区中接受了随访，在这个社区中，受感染的儿童接受了抗幽门螺杆菌治疗（n = 165），而在一个对照社区（n = 161）中接受了随访，平均随访时间为 2.5 年。每隔 3 个月进行一次人体测量，每隔 6 个月通过尿素呼气试验确定幽门螺杆菌的状态。使用重复测量混合模型比较有无感染时的个体时间生长速度。
在未治疗的社区中，83%的儿童在基线时幽门螺杆菌呈阳性，89%的儿童在研究结束时呈阳性。在治疗社区中，相应的阳性率分别为 74%和 46%。在预处理间隔内，生长速度为 0.44cm/月（标准差[SD] = 0.13cm/月）。调整年龄、性别和身高的模型估计，幽门螺杆菌阳性儿童的平均生长速度比幽门螺杆菌阴性儿童慢 0.022cm/月（95%置信区间=0.008 至 0.035），这一结果在调整社会环境协变量后并没有明显改变。
本研究表明，慢性幽门螺杆菌感染与安第斯地区学龄儿童生长速度减慢有关。
