Atrophic gastritis as a cause of hyperhomocysteinaemia.
BACKGROUND
Hyperhomocysteinaemia is an independent risk factor for atherosclerosis. It is often related to low levels of vitamin B12 and/or folate, enzymatic co-factors of methionine metabolism. Atrophic gastritis, often caused by Helicobacter pylori infection, may impair vitamin absorption.


OBJECTIVE
To assess whether the presence of atrophic gastritis is associated with hyperhomocysteinaemia via deficiency of its vitamin co-factors.


METHODS
Thirty-one patients with atrophic gastritis were recruited. The control group consisted of 28 patients with non-atrophic gastritis, matched with patients for sex, age and body mass index. The presence and degree of gastric atrophy were assessed by histology. H. pylori infection was assessed by histology/serology. Blood samples were collected for the measurement of homocysteine, vitamin B12 and folates.


RESULTS
Multiple logistic regression analysis showed that atrophic gastritis (odds ratio, 5.3; 95% confidence interval, 1.23-25.26; chi2=5.2; P=0.01) and low vitamin B12 (odds ratio, 3.7; 95% confidence interval, 1.03-22.08; chi2=3.6; P<0.05) were both predictors of hyperhomocysteinaemia. None of the other variables considered in the analysis, including H. pylori status, showed a significant association with hyperhomocysteinaemia.


CONCLUSIONS
The present study suggests that atrophic gastritis, rather than H. pylori infection per se, may be a contributing factor to hyperhomocysteinaemia, possibly via vitamin B12 malabsorption.
Santarelli
L
L
Department of Internal Medicine, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy.
Gabrielli
M
M
Cremonini
F
F
Santoliquido
A
A
Candelli
M
M
Nista
E C
EC
Pola
P
P
Gasbarrini
G
G
Gasbarrini
A
A
D005260:Female; D005492:Folic Acid / Q000378:metabolism; D005757:Gastritis, Atrophic / Q000150:complications*; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D020138:Hyperhomocysteinemia / Q000209:etiology*; D008286:Malabsorption Syndromes / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D014805:Vitamin B 12 / Q000378:metabolism
D005492:Folic Acid; D014805:Vitamin B 12