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Long-term effect of Helicobacter pylori eradication on plasma homocysteine in elderly patients with cobalamin deficiency
  1. Marília Campos Abreu Marino1,
  2. Celso Affonso de Oliveira1,
  3. Andreia Maria Camargos Rocha2,
  4. Gifone Aguiar Rocha2,
  5. Nelma Cristina Diogo Clementino3,
  6. Leonardo França Antunes2,
  7. Ricardo Araújo Oliveira2,
  8. Almir Sousa Martins4,
  9. Helen Lima Del Puerto4,
  10. Vânia D’Almeida6,
  11. Luciano Galdieri6,
  12. Ênio Roberto Pietra Pedroso1,
  13. Mônica Maria Demas Álvares Cabral5,
  14. Ana Margarida Miguel Ferreira Nogueira5,
  15. Dulciene Maria Magalhães Queiroz2
  1. 1Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  2. 2Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  3. 3Hematology Service, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  4. 4Department of Physiology and Biophysics, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  5. 5Department of Pathology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  6. 6Laboratory of Inborn Errors of Metabolism, Universidade Federal de São Paulo, São Paulo, Brazil
  1. Correspondence to:
    Dulciene Maria Magalhães Queiroz
    Laboratory of Research in Bacteriology; Faculdade de Medicina, Av. Alfredo Balena, 190/4026-30130-100, Belo Horizonte, MG, Brazil; dqueiroz{at}medicina.ufmg.br

Abstract

Background:Helicobacter pylori gastritis may lead to impairment of the production of pepsinogen and acid, which are essential to cobalamin absorption. In turn, cobalamin deficiency leads to hyperhomocysteinaemia, a risk factor for cardio and cerebrovascular diseases.

Aim: To evaluate the effect of H pylori eradication on plasma homocysteine levels in elderly patients.

Patients: Sixty-two H pylori-positive elderly patients with cobalamin deficiency were prospectively studied.

Methods: Homocysteine and cobalamin concentrations were determined before, 6 and 12 months after H pylori eradication.

Results: Corpus atrophy was observed in a few patients; otherwise, in most of them, the degree of corpus gastritis was moderate to severe. The initial homocysteine mean (SD) levels decreased from 41.0 (27.1) to 21.6 (10.1) μmol/l at the 6 month follow-up (p<0.001) and to 13.1 (3.8) μmol/l 12 months after H pylori eradication (p<0.001). Conversely, initial cobalamin mean levels increased from 145.5 (48.7) pmol/l to 209.8 (87.1) pmol/l and to 271.2 (140.8) pmol/l, 6 and 12 months after treatment, respectively (p<0.001 for both). Although the erythrocyte mean corpuscular volume was within reference intervals, it decreased significantly 6 (p = 0.002) and 12 (p<0.001) months after treatment.

Conclusions: The results of the current study demonstrated that the eradication of H pylori in elderly patients with cobalamin deficiency is followed by increasing of cobalamin and decreasing of homocysteine blood levels.

  • CFU, colony forming units
  • MCV, mean corpuscular volume
  • 13C-UBT, 13C-urea breath test
  • DOB, delta over baseline
  • helicobacter pylori
  • hyperhomocysteinaemia
  • cobalamin
  • elderly

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Footnotes

  • Published Online First 27 September 2006

  • Supported by research grants from Fundação de Apoio a Pesquisa do Estado de Minas Gerais–FAPEMIG and Conselho Nacional de Desenvolvimento Científico e Tecnológico–CNPq/Brazil

  • Competing interests: None.

  • The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non-exclusive for government employees) on a worldwide basis to the BMJ Pbulishing Group Ltd and its Licensees to permit this article (if accepted) to be published in Gut editions and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence (http://gut.bmjjournals.com/ifora/licence.dtl).

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