Department of Gastroenterology, Istanbul Medeniyet University, Goztepe Education and Research Hospital, 34470 Istanbul, Turkey.
World J Gastroenterol. 2013 Apr 21;19(15):2388-94. doi: 10.3748/wjg.v19.i15.2388.
To investigate changes in serum ghrelin and obestatin levels before and after Helicobacter pylori (H. pylori) eradication.
A total of 92 patients presenting with symptoms of dyspepsia were enrolled in the study. Upper endoscopy was performed on all patients and used to diagnose H. pylori infection according to the presence of characteristic histopathological findings; seventy patients were diagnosed with H. pylori infection and the remaining 22 non-infected patients were classified as healthy controls. H. pylori eradication was accomplished by administering the classical triple therapy drug regimen, consisting of lansoprazole 30 mg bid, amoxicillin 1 g bid, and clarithromycin 500 mg tid for 14 d. The eradication of H. pylori was assessed with C¹⁴-urea breath test, which was performed at eight weeks after treatment. Levels of serum active ghrelin and obestatin were assessed at beginning of the study (prior to treatment) and after eight weeks. The levels were comparatively analyzed between the H. pylori negative control group, the H. pylori eradicated group, and the H. pylori non-eradicated group.
A total of 92 patients, 50 females and 42 males with a mean age of 38.2 ± 11.9 years (range: 19-64), were analyzed. H. pylori eradication success was achieved in 74.3% (52/70) of H. pylori positive patients. The initial levels of ghrelin in the H. pylori positive and control cases were 63.6 ± 19.8 pg/mL and 65.1 ± 19.2 pg/mL (P = 0.78), respectively, and initial obestatin levels were 771 ± 427 pg/mL and 830 ± 296 pg/mL (P = 0.19), respectively. The difference between the initial levels and the week 8 levels of ghrelin and obestatin in the control group was insignificant [4.5% (P = 0.30) and -0.9% (P = 0.65), respectively]. The difference between the initial and week 8 levels of ghrelin and obestatin in the H. pylori non-eradicated group were also insignificant [0.9% (P = 0.64) and 5.3% (P = 0.32), respectively]. The H. pylori eradicated group had a greater change in obestatin levels when compared to the control and the non-eradicated groups (148 ± 381 pg/mL vs -12 ± 138 pg/mL and -72.8 ± 203 pg/mL, respectively, P = 0.015), while decreases in ghrelin levels were insignificant (-7.2 pg/mL vs -1.4 pg/mL and -1.9 pg/mL, respectively, P = 0.52). The ghrelin/obestatin ratio for the initial and week 8 levels changed significantly in only the H. pylori eradicated group (0.11 vs 0.08, respectively, P = 0.015). For overweight patients (as designated by body mass index), we observed significant increases in obestatin levels in the eradicated group as compared to non-eradicated group (201 ± 458 pg/mL vs -5 ± 81 pg/mL, respectively, P = 0.02). In the H. pylori-eradicated group, the levels did not differ between the sexes for ghrelin (-6.3 ± 26.9 pg/mL vs -8.0 ± 24.0 pg/mL, respectively, P = 0.97) or obestatin (210 ± 390 pg/mL vs 96 ± 372 pg/mL, respectively, P = 0.23).
Serum levels of ghrelin decreased while obestatin levels increased in H. pylori eradicated subjects, especially in overweight and male patients.
研究幽门螺杆菌（H. pylori）根除前后血清ghrelin 和 obestatin 水平的变化。
共纳入 92 例有消化不良症状的患者。所有患者均行上消化道内镜检查，并根据特征性组织病理学发现诊断 H. pylori 感染；70 例患者诊断为 H. pylori 感染，其余 22 例非感染患者为健康对照组。采用经典三联疗法药物兰索拉唑 30mg bid、阿莫西林 1g bid 和克拉霉素 500mg tid 治疗 14d 根除 H. pylori。治疗 8 周后用¹⁴C-尿素呼气试验评估 H. pylori 的根除情况。在研究开始时（治疗前）和 8 周后评估血清活性 ghrelin 和 obestatin 水平。比较 H. pylori 阴性对照组、H. pylori 根除组和 H. pylori 未根除组之间的水平。
共分析了 92 例患者，其中女性 50 例，男性 42 例，平均年龄 38.2±11.9 岁（19-64 岁）。H. pylori 阳性患者的 H. pylori 根除成功率为 74.3%（52/70）。H. pylori 阳性和对照组病例的初始 ghrelin 水平分别为 63.6±19.8pg/mL 和 65.1±19.2pg/mL（P=0.78），初始 obestatin 水平分别为 771±427pg/mL 和 830±296pg/mL（P=0.19）。对照组初始水平和第 8 周水平的 ghrelin 和 obestatin 差异无统计学意义[4.5%（P=0.30）和-0.9%（P=0.65）]。H. pylori 未根除组的 ghrelin 和 obestatin 初始水平和第 8 周水平的差异也无统计学意义[0.9%（P=0.64）和 5.3%（P=0.32）]。与对照组和未根除组相比，H. pylori 根除组的 obestatin 水平变化更大（148±381pg/mL 比-12±138pg/mL 和-72.8±203pg/mL，P=0.015），而 ghrelin 水平下降无统计学意义（-7.2pg/mL 比-1.4pg/mL 和-1.9pg/mL，P=0.52）。只有 H. pylori 根除组的 ghrelin/obestatin 比值在初始和第 8 周水平均有显著变化（0.11 比 0.08，P=0.015）。对于超重患者（根据体重指数指定），与未根除组相比，根除组的 obestatin 水平显著升高（201±458pg/mL 比-5±81pg/mL，P=0.02）。在 H. pylori 根除组中，ghrelin（-6.3±26.9pg/mL 比-8.0±24.0pg/mL，P=0.97）或 obestatin（210±390pg/mL 比 96±372pg/mL，P=0.23）的水平在性别之间无差异。
H. pylori 根除后，ghrelin 血清水平降低，obestatin 水平升高，尤其是在超重和男性患者中。
