Insulin-like growth factor-I in Helicobacter pylori gastritis and response to eradication using bismuth based triple therapy

Helicobacter pylori Infection in Children: Nutritional Status and Associations with Serum Leptin, Ghrelin, and IGF-1 Levels

BACKGROUND

Helicobacter pylori is associated with gastrointestinal diseases such as gastritis, peptic ulcers, malignancy and lymphoma, and extra-gastrointestinal conditions. H. pylori infection is negatively associated with children's growth. Chronic inflammation of the stomach that results in the loss of appetite and, dysregulation of neuroendocrine hormones such as leptin, and ghrelin are the probable reasons of this negative association. The objective of this study is to determine the serum levels of leptin, ghrelin, and IGF-1 in H. pylori-infected children and their relations with growth.

MATERIALS AND METHODS

A hundred and sixty-one school children aged between 6 and 14 years were selected randomly from five primary schools representing a cross section of population. Demographic and sociocultural characteristics, and anthropometric measurements were recorded. Serum H. pylori IgG, insulin-like growth factor-1, leptin, and ghrelin levels were measured in all children. The children were grouped according to the nutritional status and Helicobacter pylori seropositivity. Nutritional indices were compared among groups in association with serum leptin, ghrelin, and insulin-like growth factor-1 levels.

RESULTS

H. pylori IgG positivity was found in 34.2%, and 14.9% of children were malnourished. H. pylori seropositivity was significantly higher in older ages (10.32 ± 2.26 vs 9.53 ± 2.36 years, p = .036), and body weight and height Z scores were significantly lower in H. pylori-seropositive children (-0.33 ± 1.08 vs 0.04 ± 1.26, p = .044 and 0.13 ± 0.92 vs 0.23 ± 0.91, p = .018 respectively). H. pylori seropositivity was found to be an independent risk factor for shorter body height (p = .01). Serum leptin, ghrelin, and IGF-1 levels were not associated with H. pylori IgG seropositivity (0.35 vs 0.55 ng/mL, p = .3; 3267.4 ± 753.0 vs 2808.3 ± 911.4 pg/mL, p = .06; 470 ± 176 vs 521 ± 179 ng/mL, p = .32, respectively).

CONCLUSIONS

Children infected with H. pylori are prone to short stature. This effect seems to be independent of neuroendocrine hormones.

Helicobacter pylori eradication does not change circulating insulin-like growth factor 1 and insulin-like growth factor binding protein 3 levels in patients with and without precancerous gastric lesions

BACKGROUND

Circulating insulin-like growth factor (IGF)-1 and IGF-binding protein (IGFBP)-3 levels in the serum of Helicobacter pylori (H pylori)-infected patients were investigated.

METHODS

The study subjects consisted of 54 patients with H pylori infection, and the control subjects included 27 patients without H pylori infection. There was no statistical difference in the age and sex distributions between the study and control groups. Pretreatment serum levels of IGF-1 and IGFBP-3 were studied in all the subjects, including the healthy controls. H pylori eradication was achieved with a triple drug regimen for 2 weeks, and 1 month after this treatment, the serum levels of IGF-1 and IGFBP-3 were measured. The post-treatment H pylori status by a second gastroscopy, antral histopathology and urea breath testing was tested.

RESULTS

The pretreatment serum levels of IGF-1 and IGFBP-3 of the study and control groups were not found to be different (P > 0.05). H pylori treatment was successful in 42 patients in whom both serum IGF-1 and IGFBP-3 levels decreased with treatment, but the difference was only significant for the serum IGF-1 levels (P: 0.04). There was no change in the serum levels of IGF-1 and IGFBP-3 in the 27 patients with precancereous gastric lesions before and after successful H pylori eradication.

CONCLUSIONS

No supporting evidence of a major interaction between H pylori infection itself and H pylori-associated premalignant lesions with circulating IGFBP-3 levels could be shown. Nevertheless, successful eradication of this microorganism led to a statistically significant decrease in serum IGF-1 levels.

Serum Levels of Insulin-like Growth Factor I, II, and Binding Protein 3, Transforming Growth Factor β-1, Soluble Fas Ligand and Superoxide Dismutase Activity in Stomach Cancer Cases and Their Controls in the JACC Study

BACKGROUND: The prognosis of stomach cancer with advanced stage remains poor. New biomarkers of the disease that may contribute to establish the potential screening strategy would be of value for the early detection of individuals at high risk of the disease.

METHODS: We conducted a prospective, nested case-control analysis among apparently healthy men and women who were followed for up to 8 years in the Japan Collaborative Cohort (JACC) Study, to evaluate serum levels of insulin-like growth factor I, II, and binding protein 3 (IFG-I, IGF-II, and IGFBP-3), transforming growth factor β-1 (TGF β1), soluble fas (sFas) and superoxide dismutase activity (SOD) in 210 stomach cancer cases diagnosed in the JACC Study in relation to those levels in their 410 controls.

RESULTS: Among 6 serum biomarkers tested for case-control differences, only sFas level in female stomach cancer cases was significantly higher than that of controls (2.22 pg/ml vs. 2.04 pg/mL, respectively; P = 0.013 by two-way analysis of covariance controlling for matching variable).

CONCLUSION: None of the biomarkers consistently predicted future risk of stomach cancer in both men and women in the present analysis. Serum sFas level in women, however, should be studied much more thoroughly whether it provides meaningful refinement of risk stratification, or it elucidate the mechanisms of tumorigenesis in women.