Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2018; 24(3): 397-407
Published online Jan 21, 2018. doi: 10.3748/wjg.v24.i3.397
Helicobacter pylori and corpus gastric pathology are associated with lower serum ghrelin
Paula Mantero, Gonzalo Sebastián Matus, Rodolfo Ernesto Corti, Ana María Cabanne, Gerardo Gabriel Zerbetto de Palma, Liliana Marchesi Olid, María Marta Piskorz, Marcela Beatriz Zubillaga, Mariana Andrea Janjetic, Cinthia Gabriela Goldman
Paula Mantero, Gerardo Gabriel Zerbetto de Palma, Marcela Beatriz Zubillaga, Mariana Andrea Janjetic, Cinthia Gabriela Goldman, Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Física, Buenos Aires C1113AAD, Argentina
Gonzalo Sebastián Matus, Rodolfo Ernesto Corti, Hospital de Gastroenterología “Dr. Carlos Bonorino Udaondo”, Sección Esófago-Estómago, Buenos Aires C1264AAA, Argentina
Ana María Cabanne, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo”, Unidad Patología, Buenos Aires C1264AAA, Argentina
Gerardo Gabriel Zerbetto de Palma, Universidad de Buenos Aires - CONICET, Facultad de Medicina, Instituto de Microbiología y Parasitología Médica (IMPAM), Buenos Aires C1121ABG, Argentina
Liliana Marchesi Olid, Mariana Andrea Janjetic, Universidad de Buenos Aires, Facultad de Medicina, Escuela de Nutrición, Buenos Aires C1121ABG, Argentina
María Marta Piskorz, Hospital de Clínicas “José de San Martín”, División Gastroenterología, Buenos Aires C1120AAR, Argentina
Marcela Beatriz Zubillaga, Mariana Andrea Janjetic, Cinthia Gabriela Goldman, National Scientific and Technical Research Council (CONICET), Buenos Aires C1425FQB, Argentina
Author contributions: Janjetic MA and Goldman CG formulated the research questions and designed the study; Mantero P, Matus GS, Corti RE, Zerbetto de Palma GG, Marchesi Olid L and Piskorz MM collected samples and data; Mantero P, Cabanne AM, Zerbetto de Palma GG and Goldman CG performed experiments; Janjetic MA performed the statistical analysis; Mantero P, Zubillaga MB, Janjetic MA and Goldman CG interpreted data; Mantero P, Janjetic MA and Goldman CG wrote the article; all authors have read and approved the final manuscript.
Supported by the Universidad de Buenos Aires (UBA), Buenos Aires, Argentina, No. UBACYT 20020100100837 and No. UBACYT 20020130100645BA to Goldman CG; and the International Atomic Energy Agency (IAEA), Vienna, Austria, Coordinated Research Project (CRP) E43025 No. ARG-16746 to Goldman CG. UBA and IAEA had no role in the design, analysis or writing of the present article.
Institutional review board statement: The study was reviewed and approved by the Hospital de Gastroenterología “Dr. Carlos Bonorino Udaondo” and the Hospital de Clínicas “José de San Martín” Institutional Review Boards.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cinthia Gabriela Goldman, PhD, Adjunct Professor, Research Scientist, Physics Department, School of Pharmacy and Biochemistry, University of Buenos Aires, Junín 956, Buenos Aires C1113AAD, Argentina. cgold@ffyb.uba.ar
Telephone: +54-11-52874551 Fax: +54-11-52874563
Received: November 4, 2017
Peer-review started: November 4, 2017
First decision: November 14, 2017
Revised: November 30, 2017
Accepted: December 4, 2017
Article in press: December 4, 2017
Published online: January 21, 2018

To evaluate the association of Helicobacter pylori (H. pylori), cagA genotype, and type of gastric pathology with ghrelin, leptin and nutritional status.


Fasted dyspeptic adults (18-70 years) referred for an upper digestive endoscopy were enrolled in this cross-sectional study. Height and weight were assessed for body mass index (BMI) calculation. A sociodemographic survey was administered and nutrient intake was evaluated with 24 h dietary recalls. Serum total ghrelin and leptin levels were analyzed by enzyme-linked immunosorbent assay. 13C-Urea Breath Test was performed and four gastric biopsies were obtained during endoscopy for histopathology and H. pylori DNA amplification and genotyping. Data analysis was performed using χ2, Mann-Whitney U, Kruskal-Wallis tests, Spearman’s correlation and linear regression.


One hundred and sixty-three patients (40.8 ± 14.0 years), 98/65 females/males, were included. Overall, persistent H. pylori prevalence was 53.4% (95%CI: 45.7%-65.8%). Neither nutrient intake nor BMI differed significantly between H. pylori positive and negative groups. Serum ghrelin was significantly lower in infected patients [median 311.0 pg/mL (IQR 230.0-385.5)] than in uninfected ones [median 355.0 pg/mL (IQR 253.8-547.8)] (P = 0.025), even after adjusting for BMI and gender (P = 0.03). Ghrelin levels tended to be lower in patients carrying cagA positive strains both in the antrum and the corpus; however, differences with those carrying cagA negative strains did not reach statistical significance (P = 0.50 and P = 0.49, respectively). In addition, the type and severity of gastric pathology in the corpus was associated with lower serum ghrelin (P = 0.04), independently of H. pylori status. Conversely, leptin levels did not differ significantly between infected and uninfected patients [median 1.84 ng/mL (0.80-4.85) vs 1.84 ng/mL (0.50-5.09), (P = 0.51)].


H. pylori infection and severity of gastric corpus pathology are associated with lower serum ghrelin. Further studies could confirm a lower ghrelin prevalence in cagA-positive patients.

Keywords: Helicobacter pylori, cagA, Ghrelin, Leptin, Pathology

Core tip: The relationship between Helicobacter pylori (H. pylori) infection and hormonal modulation of food intake is still controversial. We conducted this study to evaluate the association between H. pylori infection, the genotype of infecting strains and the type of gastric pathology, with serum ghrelin and leptin concentrations and anthropometric nutritional status of dyspeptic patients. Our study demonstrated that H. pylori infection and the severity of gastric pathology of the corpus are associated with lower ghrelin serum concentrations. We also observed lower, but not significantly different, ghrelin levels in patients carrying cagA positive strains, an observation that should be evaluated further in future studies.