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


OBJECTIVE
To evaluate the effect of H pylori eradication on plasma homocysteine levels in elderly patients.


METHODS
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) micromol/l at the 6 month follow-up (p<0.001) and to 13.1 (3.8) micromol/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.
Marino
Marília Campos Abreu
MC
Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
de Oliveira
Celso Affonso
CA
Rocha
Andreia Maria Camargos
AM
Rocha
Gifone Aguiar
GA
Clementino
Nelma Cristina Diogo
NC
Antunes
Leonardo França
LF
Oliveira
Ricardo Araújo
RA
Martins
Almir Sousa
AS
Del Puerto
Helen Lima
HL
D'Almeida
Vânia
V
Galdieri
Luciano
L
Pedroso
Enio Roberto Pietra
ER
Cabral
Mônica Maria Demas Alvares
MM
Nogueira
Ana Margarida Miguel Ferreira
AM
Queiroz
Dulciene Maria Magalhães
DM
D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000097:blood / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007437:Intrinsic Factor / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020116:Pepsinogen A / Q000097:blood; D011446:Prospective Studies; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000382:microbiology*
D001323:Autoantibodies; D005755:Gastrins; D006710:Homocysteine; D020116:Pepsinogen A; D007437:Intrinsic Factor