Eradication of Helicobacter pylori increases childhood growth and serum acylated ghrelin levels

Table 1 Comparison of demographic background, baseline body parameters, and the changes of growth after one-year follow-up between the Helicobacter pylori-infected and non-infected matched controls of the observation cohort (mean ± SD)

Groups	H. pylori-positive subjects	H. pylori-negative controls	P value
n	18	18
Age (yr)	9.1 ± 1.6	9.4 ± 1.7	0.57
Sex (female:male)	8:10	27:45:00	0.59
Body weight (kg)
At enrollment	29.9 ± 7.0	35.0 ± 10.1	0.02
z score at enrollment	-1.11 ± 0.47	0.35 ± 0.69	0.01
The 1st year	33.2 ± 7.5	39.5 ± 11.3	0.007
z score at the 1st year	-0.17 ± 0.45	0.38 ± 0.67	0.002
Net change	3.3 ± 2.1	4.5 ± 2.4	0.04
Body height (cm)
At enrollment	132.3 ± 11.4	136.8 ± 12.3	0.15
z score at enrollment	-0.17 ± 0.49	0.15 ± 0.73	0.07
The 1st year	138.0 ± 11.4	142.5 ± 12.4	0.15
z score at the 1st year	-0.14 ± 0.48	0.13 ± 0.71	0.1
Net change	5.7 ± 0.9	5.8 ± 1.9	0.81
BMI (kg/m2)
At enrollment	16.8 ± 1.6	18.4 ± 2.8	0.03
z score at enrollment	0.06 ± 0.45	0.44 ± 0.73	0.02
The 1st year	17.2 ± 1.7	19.0 ± 3.0	0.01
z score at the 1st year	0 ± 0.38	0.45 ± 0.75	0.01
Net change	0.35 ± 0.8	0.69 ± 1.0	0.14

BMI: Body mass index; H. Pylori: Helicobacter pylori; Net change: The growth parameters at the 1st year minus that at enrollment.

Table 2 Comparison of the demographic background, baseline body parameters, and the changes of growth among the different groups of the intervention cohort completed the one-year follow-up (mean ± SD)

Groups	H. pylori eradication failure	H. pylori eradication success	H. pylori-negative controls
n	17	34	153
Age (yr)	8.4 ± 1.9	8.7 ± 2.0	9.0 ± 1.7
Sex (female:male)	10:07	19:15	81 : 72
Family peptic ulcer history (%)	44.4	29.4	21
Intra-familial members ≥ 5 (%)	33.3	29.4	32.1
Low income (%)	28.6	53.3	44.1
Baseline serum acylated ghrelin (pg/mL)ac	37.2 ± 31.4	44.2 ± 37.9	83.6 ± 24.2
Body weight (kg)
At enrollment	32.2 ± 10.6	32.9 ± 11.4	36.1 ± 11.4
z score at enrollment	0.44 ± 1.00	0.35 ± 1.04	0.60 ± 0.87
The 1st year	37.2 ± 11.7	38.7 ± 13.8	41.0 ± 12.6
z score at the 1st year	0.56 ± 0.88	0.49 ± 1.03	0.61 ± 0.88
Net changec	5.03 ± 2.77	5.84 ± 3.37	4.84 ± 2.35
Increase of z score (%)c	23.5	38.2	17.6
Body height (cm)
At enrollment	134.6 ± 12.7	134.3 ± 11.7	135.7 ± 12.5
z score at enrollment	0.62 ± 0.99	0.44 ± 0.88	0.33 ± 0.77
The 1st year	141.8 ± 11.8	142.3 ± 12.8	141.5 ± 13.0
z score at the 1st yearac	0.77 ± 0.94	0.63 ± 0.75	0.32 ± 0.79
Net changec,e	7.20 ± 2.85	8.00 ± 2.78	5.85 ± 1.81
Increase of z score (%)c	35.3	35.3	15.7
BMI (kg/m2)
At enrollmenta	17.1 ± 2.6	17.7 ± 4.1	19.0 ± 3.7
z score at enrollmentc	0.24 ± 0.75	0.21 ± 1.14	0.68 ± 0.87
The 1st year	18.1 ± 3.1	18.8 ± 4.7	20.0 ± 3.8
z score at the 1st yearc	0.35 ± 0.82	0.27 ± 1.12	0.67 ± 0.87
Net change	0.98 ± 1.57	1.10 ± 1.56	0.99 ± 1.03
Increase of z score (%)	35.3	32.4	17

Low income: Indicated < $15000 US/year. Increase of z score means that z scores of body weight, height and body mass index (BMI) were upgrade at the one-year follow-up than at the enrollment (the net change > 0). The difference of the body weight, height, BMI and ghrelin level among the three groups were analyzed by oneway analysis of variance model with least significant difference correction. The difference of the up-shift of the z scores of body weight, height and BMI were analyzed by χ² test.

^aP < 0.05 between H. pylori-positive subjects with eradication failure and controls,

^cP < 0.05 between H. pylori-positive subjects with eradication success and controls.

Table 3 The differences of the baseline serum acylated ghrelin levels between the children with body weight above and below the cut-off point selected based on the different age ranges of children (mean ± SD)

	H. pylori infection		Non-H. pylori infection
Age ranges (yr)	4-7	8-12	4-7	8-12
BW cut-off point, kg (n)	26 (21)	36 (32)	26 (47)	36 (87)
Baseline serum acylated ghrelin (pg/mL)
Above or equal to the BW cut-off point	51.3 ± 38.6	51.8 ± 40.9	78.2 ± 12.0	85.9 ± 26.9
Below the BW cut-off point	47.8 ± 36.5	23.8 ± 22.1	82.5 ± 17.2	83.8 ± 31.2
1P value	0.93	0.02	0.31	0.78
z score of BW cut-off point (n)	0.5 (18)	0.5 (35)	0.5 (28)	0.5 (106)
Baseline serum acylated ghrelin (pg/mL)
Above or equal to the z score of BW cut-off point	53.4 ± 40.6	46.8 ± 38.9	81.3 ± 14.1	81.7 ± 19.7
Below the z score of BW cut-off point	45.9 ± 33.6	27.3 ± 26.5	81.9 ± 16.6	89.6 ± 36.4
1P value	0.68	0.09	0.91	0.15

¹The P value indicated the difference of serum acylated ghrelin levels between the children with body weight (BW) and z score of BW above or equal to the cut-off point and those with below the cut-off point within the same age ranges, analyzed by the Student’s t test. The BW (z score of BW) cut-off point was determined by the mean (median) of non-Helicobacter pylori (H. pylori) infected children within the same age ranges.