Pinar Ibrahim E, Mavis Osman
Department of Internal Medicine, Division of Hematology, Isparta City Hospital, Isparta, TUR.
Department of Internal Medicine, Health Sciences University, Istanbul Gaziosmanpasa Training and Research Hospital, Istanbul, TUR.
Cureus. 2023 Sep 14;15(9):e45252. doi: 10.7759/cureus.45252. eCollection 2023 Sep.
Introduction Chronic infection with (Hp) is an essential cause of gastrointestinal pathologies in adults. Despite being a microorganism proven to play a role in vitamin B12 deficiency by causing gastric atrophy, Hp's role in patients with non-atrophic gastritis has not been fully explained. Our study investigated whether the presence and density of Hp is related to vitamin B12 and folate deficiencies in patients with non-atrophic gastritis. Methods This retrospective cohort study analyzed the following parameters, vitamin B12, folate, and mean red blood cell volume (MCV) in the hemogram; these were measured simultaneously in patients diagnosed with non-atrophic gastritis who had undergone gastroscopy to investigate Hp levels. Patients with conditions that could have caused vitamin B12 and folate deficiencies were excluded from the study. The study included 244 patients who met the criteria. The Sydney classification was used for histopathologic grading and staging of gastric biopsies of patients with gastritis. Results There was no relationship between the presence and density of Hp with vitamin B12 levels. However, folate levels were significantly lower in Hp-positive patients than in Hp-negative patients (p = 0.017). Folate levels were substantially lower in patients with chronic pan-mucosal gastritis than in patients with chronic inactive gastritis (p = 0.034). Statistically, a significant difference was found between folate levels on the basis of neutrophil activity and inflammation score (p = 0.011 and p <0.001, respectively). Conclusions Although there was no statistically significant relationship between the presence and density of Hp and vitamin B12, our study found an association between folate levels and Hp density. This may be associated with the time for the depletion of vitamin B12 and folate stores and the relatively early stage of gastritis. In cases with vitamin B12 and folate deficiencies, appropriate studies should be performed for specific epidemiological reasons in respective fields.
引言 幽门螺杆菌(Hp)慢性感染是成人胃肠道疾病的重要病因。尽管已证实该微生物通过引起胃萎缩在维生素B12缺乏中起作用,但其在非萎缩性胃炎患者中的作用尚未完全阐明。我们的研究调查了非萎缩性胃炎患者中Hp的存在及密度是否与维生素B12和叶酸缺乏有关。方法 这项回顾性队列研究分析了血常规中的以下参数:维生素B12、叶酸和平均红细胞体积(MCV);这些参数是在接受胃镜检查以检测Hp水平的非萎缩性胃炎患者中同时测量的。可能导致维生素B12和叶酸缺乏的疾病患者被排除在研究之外。该研究纳入了244名符合标准的患者。采用悉尼分类法对胃炎患者的胃活检进行组织病理学分级和分期。结果 Hp的存在及密度与维生素B12水平之间无相关性。然而,Hp阳性患者的叶酸水平显著低于Hp阴性患者(p = 0.017)。慢性全黏膜胃炎患者的叶酸水平显著低于慢性非活动性胃炎患者(p = 0.034)。在统计学上,根据中性粒细胞活性和炎症评分,叶酸水平存在显著差异(分别为p = 0.011和p <0.001)。结论 尽管Hp的存在及密度与维生素B12之间无统计学显著相关性,但我们的研究发现叶酸水平与Hp密度之间存在关联。这可能与维生素B12和叶酸储备的消耗时间以及胃炎的相对早期阶段有关。在存在维生素B12和叶酸缺乏的情况下,应针对各自领域的特定流行病学原因进行适当研究。