Departments of Pediatrics and Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan 70428, Taiwan, China.
World J Gastroenterol. 2012 Jun 7;18(21):2674-81. doi: 10.3748/wjg.v18.i21.2674.
To determine whether Helicobacter pylori (H. pylori)-infected children have reduced body weight (BW) and height (BH) growth, and if H. pylori eradication may restore growth while improving serum acylated ghrelin.
This longitudinal cohort study with one-year follow-up enrolled 1222 children aged 4 to 12 years old into an observation cohort (18 with and 318 without H. pylori) and intervention cohort (75 with and 811 without). The 7-d triple therapy was used for eradication in the intervention cohort. The net increases of BW and BH as well serum acylated ghrelin after one-year follow-up were compared between successful eradicated H. pylori-infected children and controls.
In the observation cohort, the H. pylori-infected children had lower z score of BW (-1.11 ± 0.47 vs 0.35 ± 0.69, P = 0.01) and body mass index (BMI) (0.06 ± 0.45 vs 0.44 ± 0.73, P = 0.02) at enrollment and lower net BW gain after one-year follow-up (3.3 ± 2.1 kg vs 4.5 ± 2.4 kg, P = 0.04) than the non-infected controls. In the intervention cohort, the H. pylori-infected children had lower z score of BMI (0.25 ± 1.09 vs 0.68 ± 0.87, P = 0.009) and serum acylated ghrelin levels (41.8 ± 35.6 pg/mL vs 83.6 ± 24.2 pg/mL, P < 0.001) than the non-infected controls. In addition to restoring decreased serum ghrelin levels (87.7 ± 38.0 pg/mL vs 44.2 ± 39.0 pg/mL, P < 0.001), the H. pylori-infected children with successful eradication had higher net gains (P < 0.05) and increase of z scores (P < 0.05) of both BW and BH as compared with non-infected controls after one-year follow-up.
H. pylori-infected children are associated with low serum acylated ghrelin and growth retardation. Successful eradication of H. pylori restores ghrelin levels and increases growth in children.
确定幽门螺杆菌（H. pylori）感染儿童的体重（BW）和身高（BH）增长是否减少，以及 H. pylori 根除是否可以在改善血清酰化胃饥饿素的同时恢复生长。
这项为期一年的随访的纵向队列研究纳入了 1222 名 4 至 12 岁的儿童进入观察队列（18 名 H. pylori 感染和 318 名非 H. pylori 感染）和干预队列（75 名 H. pylori 感染和 811 名非 H. pylori 感染）。干预队列采用 7 天三联疗法进行根除。比较一年随访后成功根除 H. pylori 感染儿童与对照组的 BW 和 BH 净增长以及血清酰化胃饥饿素水平。
在观察队列中，H. pylori 感染儿童在入组时的 BW （-1.11 ± 0.47 与 0.35 ± 0.69，P = 0.01）和 BMI （0.06 ± 0.45 与 0.44 ± 0.73，P = 0.02）的 z 评分较低，一年随访后的 BW 净增长也较低（3.3 ± 2.1 kg 与 4.5 ± 2.4 kg，P = 0.04）。在干预队列中，H. pylori 感染儿童的 BMI （0.25 ± 1.09 与 0.68 ± 0.87，P = 0.009）和血清酰化胃饥饿素水平（41.8 ± 35.6 pg/mL 与 83.6 ± 24.2 pg/mL，P < 0.001）均低于非感染对照组。除了恢复降低的血清胃饥饿素水平（87.7 ± 38.0 pg/mL 与 44.2 ± 39.0 pg/mL，P < 0.001）外，成功根除 H. pylori 的 H. pylori 感染儿童在一年随访后的 BW 和 BH 的净增长（P < 0.05）和 z 评分增加（P < 0.05）均高于非感染对照组。
H. pylori 感染儿童与低血清酰化胃饥饿素和生长迟缓有关。成功根除 H. pylori 可恢复儿童的胃饥饿素水平并促进其生长。
