TITLE

PLASMA GHRELIN FOLLOWING CURE OF HELICOBACTER PYLORI

AUTHOR(S)
Freshwater, D.; Randeva, H.S.; O'Hare, P.; Nwokolo, C.U.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA17
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In the Western world, the incidence of oesophageal adenocarcinoma has increased over the past 30 years, coinciding with a decrease in the prevalence of H pylori. Trends of increasing oesophageal adenocarcinoma can be linked causally to increasing gastroesophagea 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 that regulates appetite, food intake, and body composition, is studied in H pylori positive asymptomatic subjects. Methods: Plasma ghrelin, leptin, and gastrin were measured For 6 h after an overnight fast, before and after cure of H pylori in 10 subjects; 24 h intragastric acidity was also assessed. Results: After cure median (95% CIs) integrated plasma ghrelin increased from 1160.5 (765.5-1451) pg/ml/h to 1910.4 (1675.62395.6) pg/ml/h (p = 0.002 Wilcoxon Rank Sum Test), a 75% increase. This was associated with a 14% increase in 24 h intragastric acidity (p = 0.006). There was a significant positive correlation between plasma ghrelin and intragastric acidity (rs 0.44, p = 0.05, Spearman rank correlation) and no significant change in leptin or gastrin. Conclusions: After H pylori cure, plasma ghrelin increases 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 Iow. This plausible biological mechanism links H pylori, through increasing obesity and GORD, to the increase in oesophageal adenocarcinoma observed in the Western world.
ACCESSION #
9747368

 

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