Emiralioglu Nagehan, Yenicesu Idil, Sari Sinan, Egritas Odul, Poyraz Aylar, Pasaoglu Ozge Tugce, Celik Bulent, Dalgic Buket
Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey,
Eur J Pediatr. 2015 Jul;174(7):903-10. doi: 10.1007/s00431-014-2482-4. Epub 2015 Jan 9.
The link between Helicobacter pylori and iron deficiency (ID) or iron deficiency anemia (IDA) has been investigated recently. We suggested that IDA/ID associated with H. pylori infection might be mediated by inflammation-driven hepcidin production. Patients with complaints of recurrent abdominal pain and dyspepsia aged between 7-16 years were included in this study. Patients were divided into two groups according to H. pylori status in upper gastrointestinal endoscopy. Group I who had H. pylori gastritis (n=50) received triple antibiotic therapy. Group II (n=50) who had H. pylori-negative gastritis only received proton pump inhibitor. Thirty healthy children with the similar age and gender were included in the study as a control group. Complete blood count, serum iron levels, iron-binding capacity, ferritin levels, prohepcidin and interleukin-6 (IL-6) values were evaluated in all children at the first visit. Initial tests were repeated after H. pylori eradication. Initial levels of ferritin (p=0.002), prohepcidin (p=0.003), and IL-6 (p=0.004) were found significantly lower in group I compared to group II and the control group. The mean prohepcidin level was lower in the anemic H. pylori-positive group than in non-anemic H. pylori-positive group; however, the difference was not statistically significant. While significant increases in hematocrit and mean corpuscular volume were observed, no significant difference was found in serum ferritin, prohepcidin, or IL-6 level after eradication treatment in H. pylori-positive group.
H. pylori-induced gastritis appears to cause an increase in prohepcidin levels and a decrease in ferritin levels, supporting our hypothesis; but this relationship has not been proven.
幽门螺杆菌与缺铁(ID)或缺铁性贫血(IDA)之间的联系最近已得到研究。我们认为,与幽门螺杆菌感染相关的IDA/ID可能由炎症驱动的铁调素产生介导。本研究纳入了7至16岁有反复腹痛和消化不良主诉的患者。根据上消化道内镜检查的幽门螺杆菌状态将患者分为两组。第一组为幽门螺杆菌胃炎患者(n = 50),接受三联抗生素治疗。第二组(n = 50)仅患有幽门螺杆菌阴性胃炎,仅接受质子泵抑制剂治疗。30名年龄和性别相似的健康儿童作为对照组纳入研究。在所有儿童首次就诊时评估全血细胞计数、血清铁水平、铁结合能力、铁蛋白水平、前铁调素和白细胞介素-6(IL-6)值。在根除幽门螺杆菌后重复进行初始检测。发现第一组的铁蛋白(p = 0.002)、前铁调素(p = 0.003)和IL-6(p = 0.004)初始水平与第二组和对照组相比显著降低。贫血的幽门螺杆菌阳性组的平均前铁调素水平低于非贫血的幽门螺杆菌阳性组;然而,差异无统计学意义。虽然观察到血细胞比容和平均红细胞体积显著增加,但幽门螺杆菌阳性组根除治疗后血清铁蛋白、前铁调素或IL-6水平无显著差异。
幽门螺杆菌引起的胃炎似乎导致前铁调素水平升高和铁蛋白水平降低,支持我们的假设;但这种关系尚未得到证实。