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. 2003 May;52(5):637-40.
doi: 10.1136/gut.52.5.637.

Plasma ghrelin following cure of Helicobacter pylori

C U Nwokolo  1 , D A Freshwater, P O'Hare, H S Randeva
Affiliations

Plasma ghrelin following cure of Helicobacter pylori

C U Nwokolo et al. Gut. 2003 May.

Abstract

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 x h to 1910.4 (1675.6-2395.6) pg/ml x 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 (r(s) 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.

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Figures

Figure 1
Figure 1
Median (95% confidence intervals) hourly plasma ghrelin concentrations in 10 healthy subjects before and after cure of Helicobacter pylori. Breakfast was at 0815 hours and tea at 1045 hours.
Figure 2
Figure 2
Six hour integrated plasma ghrelin in 10 healthy subjects before and after cure of Helicobacter pylori.
Figure 3
Figure 3
Median hourly plasma leptin concentrations in 10 healthy subjects before and after cure of Helicobacter pylori.
Figure 4
Figure 4
Six hour integrated plasma leptin in 10 healthy subjects before and after cure of Helicobacter pylori.
Figure 5
Figure 5
Six hour integrated values for plasma ghrelin, leptin, gastrin, and 24 hour integrated intragastric acidity, comparing after with before cure of Helicobacter pylori (percentage change). Positive values are increases and negative values are decreases. Ghrelin and acidity increased significantly by 75% and 14%, respectively. Leptin and gastrin decreased non-significantly.
See this image and copyright information in PMC

Comment in

  • Helicobacter pylori, ghrelin, and obesity.
    Macadam RC, Borse V, Dodo I, Pollard SG. Macadam RC, et al. Gut. 2004 Feb;53(2):315-6; author reply 316. Gut. 2004. PMID: 14724173 Free PMC article. No abstract available.
  • Ghrelin and Helicobacter pylori.
    Murray CD, Emmanuel AV. Murray CD, et al. Gut. 2004 Feb;53(2):315; author reply 315. Gut. 2004. PMID: 14724174 Free PMC article. No abstract available.

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