Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2012; 18(21): 2674-2681
Published online Jun 7, 2012. doi: 10.3748/wjg.v18.i21.2674
Eradication of Helicobacter pylori increases childhood growth and serum acylated ghrelin levels
Yao-Jong Yang, Bor-Shyang Sheu, Hsiao-Bai Yang, Cheng-Chan Lu, Ching-Chun Chuang
Yao-Jong Yang, Departments of Pediatrics and Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan 70428, Taiwan, China
Bor-Shyang Sheu, Departments of Internal Medicine and Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan 70428, Taiwan, China
Hsiao-Bai Yang, Ton-Yen General Hospital, Hsinchu County 70428 Taiwan, China
Hsiao-Bai Yang, Cheng-Chan Lu, Department of Pathology, Medical College, National Cheng Kung University, Tainan 70428, Taiwan, China
Ching-Chun Chuang, Institute of Clinical Medicine, Medical College, National Cheng Kung University, Tainan 70428, Taiwan, China
Author contributions: Yang YJ contributed to the study design, study performance, and wrote the first draft of the manuscript; Yang HB and Lu CC contributed to the study design, technique consultation and paper revision; Chuang CC performed the research and analyzed the data; Sheu BS organized the whole study design, team discussion and final revision of this paper.
Supported by National Cheng Kung University Hospital, Tainan, China, No. NCKUH96-030; and DOH99-TD-C-111-003 from Department of Health, Taiwan, China, No. DOH99-TD-C-111-003
Correspondence to: Bor-Shyang Sheu, Professor, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138 Sheng Li Road, Tainan 70428, Taiwan, China. sheubs@mail.ncku.edu.tw
Telephone: +886-6-2353535 Fax: +886-6-2370941
Received: August 9, 2011
Revised: December 8, 2011
Accepted: April 28, 2012
Published online: June 7, 2012
Abstract

AIM: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Keywords: Child, Clinical trial, Ghrelin, Growth retardation, Helicobacter pylori