title: Relation of Helicobacter pylori infection to plasma vitamin B12, folic acid, and homocysteine levels in patients who underwent diagnostic coronary arteriography.
abstract: OBJECTIVE
  The aim of this study was to test the hypothesis that chronic atrophic gastritis induced by Helicobacter pylori (H. pylori) causes malabsorption of vitamin B12 and folate in food, leading ultimately to an increase in circulating homocysteine levels.
  
  
  METHODS
  We performed endoscopy with stomach biopsy and measured fasting plasma homocysteine, vitamin B12, and folate levels in 93 patients who underwent diagnostic coronary arteriography. The patients were divided into two groups according to the presence (n = 57) or absence (n = 36) of H. pylori infection. Positive H. pylori infection was defined as positive H. pylori histology of biopsy specimens from the stomach. The extent of atrophic gastritis was endoscopically graded from 0 to 6.
  
  
  RESULTS
  There were no differences in age, sex, or traditional coronary risk factors between the two groups. Atrophy scores of the stomach were greater in patients with H. pylori infection than in patients without (3.9 +/- 1.4 vs 2.2 +/- 1.8, p < 0.0001). Patients with H. pylori infection had lower levels of vitamin B12 (630 +/- 222 vs 747 +/- 259 pg/ml, p = 0.02) and folate (6.2 +/- 2.1 vs 7.4 +/- 2.8, p = 0.046), as well as higher levels of homocysteine (11 +/- 4.9 vs 8.3 +/- 2.1 nmol/ml, p = 0.01), than did patients without H. pylori infection. Plasma homocysteine levels correlated inversely with plasma vitamin B12 and folate levels and positively with atrophic scores.
  
  
  CONCLUSIONS
  This study suggests that H. pylori-induced chronic atrophic gastritis decreases plasma vitamin B12 and folic acid levels, thereby increasing homocysteine levels. However, this effect does not seem to be strong.
authors: Second Department of Internal Medicine, Oita Medical University, Hasama, Japan.
authors: Akira
authors: A
authors: Tamura
authors: Toshio
authors: T
authors: Fujioka
authors: Masaru
authors: M
authors: Nasu
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005757:Gastritis, Atrophic / Q000097:blood* / Q000209:etiology*; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008286:Malabsorption Syndromes / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12