Plasma ghrelin following cure of Helicobacter pylori

• Published in: Gut Vol. 52; no. 5; pp. 637 - 640
• Main Authors: Nwokolo, C U, Freshwater, D A, O’Hare, P, Randeva, H S
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.05.2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; Copyright 2003 by Gut
• Subjects: Adenocarcinoma - microbiology; Adult; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; BMI; BMI, body mass index; Body mass index; coefficient of variation; Confidence intervals; CV, coefficient of variation; Drug therapy; Esophageal cancer; Esophageal Neoplasms - microbiology; Female; gastric acidity; Gastric Acidity Determination; gastrin; Gastrins - blood; gastro-oesophageal reflux; Gastroesophageal reflux; Gastroesophageal Reflux - microbiology; Gastrointestinal surgery; Ghrelin; GORD; GORD, gastro-oesophageal reflux; Growth hormones; Helicobacter infections; Helicobacter Infections - blood; Helicobacter Infections - drug therapy; Helicobacter pylori; Human bacterial diseases; Humans; Infectious diseases; leptin; Leptin - blood; Male; Meals; Measurement; Medical sciences; OA, oesophageal adenocarcinoma; oesophageal adenocarcinoma; Peptide Hormones - blood; Physiological aspects; Plasma; Radioimmunoassay - methods; Risk factors; Statistical analysis; Statistics; Stomach; Trends; United Kingdom; England; United Kingdom > UK; United States > US; Wales; Adenocarcinoma; Appetite; Human; Gastroesophageal reflux; Obesity; Spirillales; Esophageal disease; Nutrition disorder; Spirillaceae; Biosynthesis; Malignant tumor; Eradication; Gastritis; Esophagus; Infection; Regulation(control); Helicobacter pylori; Bacteriosis; Digestive diseases; Bacteria; Complication; Biological effect; Nutritional status; Gastric disease
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.52.5.637

Background: In the Western world, the incidence of oesophageal adenocarcinoma has increased over the last 30 years coinciding with a decrease in the prevalence of Helicobacter pylori. Trends of increasing oesophageal adenocarcinoma can be linked causally to increasing gastro-oesophageal reflux disease (GORD) which can be linked to an increasingly obese population. However, there is no plausible biological mechanism of association between H pylori, obesity, and GORD. Ghrelin, a peptide produced in the stomach, which regulates appetite, food intake, and body composition, was studied in H pylori positive asymptomatic subjects. Methods: Plasma ghrelin, leptin, and gastrin were measured for six hours after an overnight fast, before and after cure of H pylori in 10 subjects. Twenty four hour intragastric acidity was also assessed. Results: After cure, median (95% confidence intervals) integrated plasma ghrelin increased from 1160.5 (765.5–1451) pg/ml×h to 1910.4 (1675.6–2395.6) pg/ml×h (p=0.002, Wilcoxon’s rank sum test), a 75% increase. This was associated with a 14% increase in 24 hour intragastric acidity (p=0.006) and non-significant changes in leptin and gastrin. There was a significant positive correlation between plasma ghrelin and intragastric acidity (rs 0.44, p=0.05, Spearman’s rank correlation) Conclusions: After H pylori cure, plasma ghrelin increased profoundly in asymptomatic subjects. This could lead to increased appetite and weight gain, and contribute to the increasing obesity seen in Western populations where H pylori prevalence is low. This plausible biological mechanism links H pylori, through increasing obesity and GORD, to the increase in oesophageal adenocarcinoma observed in the West.