The effect of H. pylori eradication on meal-associated changes in plasma ghrelin and leptin - PubMed (original) (raw)

Controlled Clinical Trial

The effect of H. pylori eradication on meal-associated changes in plasma ghrelin and leptin

Fritz Francois et al. BMC Gastroenterol. 2011.

Abstract

Background: Appetite and energy expenditure are regulated in part by ghrelin and leptin produced in the gastric mucosa, which may be modified by H. pylori colonization. We prospectively evaluated the effect of H. pylori eradication on meal-associated changes in serum ghrelin and leptin levels, and body weight.

Methods: Veterans referred for upper GI endoscopy were evaluated at baseline and ≥8 weeks after endoscopy, and H. pylori status and body weight were ascertained. During the first visit in all subjects, and during subsequent visits in the initially H. pylori-positive subjects and controls, blood was collected after an overnight fast and 1 h after a standard high protein meal, and levels of eight hormones determined.

Results: Of 92 enrolled subjects, 38 were H. pylori-negative, 44 H. pylori-positive, and 10 were indeterminate. Among 23 H. pylori-positive subjects who completed evaluation after treatment, 21 were eradicated, and 2 failed eradication. After a median of seven months following eradication, six hormones related to energy homeostasis showed no significant differences, but post-prandial acylated ghrelin levels were nearly six-fold higher than pre-eradication (p=0.005), and median integrated leptin levels also increased (20%) significantly (p<0.001). BMI significantly increased (5 ± 2%; p=0.008) over 18 months in the initially H. pylori-positive individuals, but was not significantly changed in those who were H. pylori-negative or indeterminant at baseline.

Conclusions: Circulating meal-associated leptin and ghrelin levels and BMI changed significantly after H. pylori eradication, providing direct evidence that H. pylori colonization is involved in ghrelin and leptin regulation, with consequent effects on body morphometry.

© 2011 Francois et al; licensee BioMed Central Ltd.

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Figures

Figure 1

Figure 1

Comparison of _H. pylori_+ persons at baseline, and then after eradication of H. pylori. A standardized meal was administered to 21 subjects, and pre-meal, post-meal, and integrated values (mean of pre-meal and post-meal) were calculated for acyl-ghrelin (Panel A) and leptin (Panel B). H. pylori+(grey), Eradicated (white). Boxes indicate median and interquartile range, and bars indicate minimum and maximum values. P-values represent significant (< 0.05) differences between the H. pylori+ and post-eradication samples.

Figure 2

Figure 2

Comparison of test-meal induced changes in plasma acyl-ghrelin and leptin levels according to H. pylori at baseline and after eradication. Data are for seven _H. pylori_-negative, 21 _H. pylori_-positive subjects including eight _H. pylori+_cagA- and 13 H. pylori+cagA+ subjects. (* P < 0.05, comparing either pre-meal to post-meal values, or **comparing the first and second evaluations). Data also are shown for all of the 38 _H. pylori_-negative subjects at baseline, for comparison with the subset who also had follow-up studies. Panel A: Ghrelin levels. Panel B: Leptin Levels.

Figure 3

Figure 3

Change in BMI in 69 study subjects over a 2-year period. BMI is calculated relative to the baseline (at time 0), and is shown from 6 months prior to baseline and during 18 months of follow-up in 38 _H. pylori_-negative, 21 _H. pylori_-eradicated, and 10 subjects who were _H. pylori_-indeterminate at baseline (*p < 0.05, comparing time 0 to other follow-up months).

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