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. 2021 Jun 23;9(7):1361.
doi: 10.3390/microorganisms9071361.

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

Michael Doulberis  1   2   3   4 , Noah Thierry Pierre  1   5 , Giulia Manzini  6 , Apostolis Papaefthymiou  3   4   7 , Jannis Kountouras  3 , Jolanta Klukowska-Rötzler  1 , Stergios A Polyzos  4 , Simone Srivastava  8 , Aristomenis K Exadaktylos  1 , Jürg Knuchel  2 , Thomas Kuntzen  2 , David S Srivastava  1   9
Affiliations

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

Michael Doulberis et al. Microorganisms. .

Abstract

Obesity, as a major risk factor of metabolic syndrome (MetS), represents a pandemic, especially in Western societies, and is considered a risk factor for malignancies. Helicobacter pylori (Hp), is a definite carcinogen with global distribution. We aimed to investigate, for the first time in Switzerland, the main gastric mucosa premalignant histological lesions of bariatric patients in correlation with MetS components and Hp Infection (Hp-I). By reviewing retrospectively 94304 patient cases, a total of 116 eligible patients having undergone bariatric surgery were identified. The mean patient age was 48.66 years. Hp(+) patients were 24% (28/116). Presence of gastric mucosa atrophy was documented in 8/28 Hp(+) patients (29%) and (2/88) Hp(-) ones (2%) (p = 0.006). Gastric mucosa intestinal metaplasia was observed in 14/28 (50%) Hp(+) patients versus 3/88 (3.4%) of Hp(-) group (p < 0.0001). Hp(+) patients exhibited statistically higher arterial hypertension (p = 0.033). The homeostatic model of assessment insulin resistance was also statistically significantly higher for the Hp(+) group (p < 0.001). In a multivariate analysis, including arterial hypertension, gastric mucosa atrophy, and intestinal metaplasia as variables, statistical significance remained only for intestinal metaplasia (p = 0.001). In conclusion, Hp-I is associated with premalignant gastric mucosa histologic lesions and MetS components, including arterial hypertension and IR. Further large-scale prospective studies are required to confirm these findings.

Keywords: GA; Helicobacter pylori; Hp; IME; MetS; bariatric; gastric atrophy; intestinal metaplasia; metabolic syndrome.

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Conflict of interest statement

Doulberis received travel grants from Gilead Sciences Switzerland Sàrl. Kuntzen received travel grants from Gilead Sciences, Vifor, Roche, Merck, Sharp & Dohme and Amgen, and Research grants from the Novartis Stiftung für klinische Forschung, and Merck, Sharp & Dohme. All other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patients undergoing bariatric surgery were significantly associated with gastric atrophy, intestinal metaplasia, arterial hypertension, and increased insulin resistance when infected with Hp, compared to the noninfected patients. HOMA–IR, homeostasis model assessment–insulin resistance method.
See this image and copyright information in PMC

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