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Long-term effect of Helicobacter pylori eradication on plasma homocysteine in elderly patients with cobalamin deficiency

2006; BMJ; Volume: 56; Issue: 4 Linguagem: Inglês

10.1136/gut.2006.095125

1468-3288

Marília Campos Abreu Marino, Cláudio Alvarenga de Oliveira, Andréia Maria Camargos Rocha, Gifone Aguiar Rocha, Nelma Clementino, Luís Antunes, Rodrigo Azevedo de Oliveira, Almir S. Martins, Helen L. Del Puerto, Vânia D’Almeida, Luciano Galdieri, Ênio Roberto Pietra Pedroso, Mônica Maria Demas Álvares Cabral, Ana Margarida Miguel Ferreira Nogueira, Dulciene Maria Magalhães Queiroz,

Helicobacter pylori-related gastroenterology studies

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.