title: The eradication of Helicobacter pylori is affected by body mass index (BMI).
abstract: BACKGROUND
  Bariatric surgeons often advocate preoperative Helicobacter pylori (H. pylori) testing and eradication because of the increased risk of postoperative ulcers and foregut symptoms in H. pylori-positive patients. The aim of this pilot study was to evaluate whether body mass index (BMI) might influence the success rate of eradication.
  
  
  METHODS
  Eighty one nondiabetic naïve H. pylori-positive patients were divided into two groups according to their BMI, with 41 in the control group (normal BMI) and 40 in the overweight/obese group (BMI > or = 25). Gastroscopy was performed and multiple biopsies were obtained from the antrum and corpus. Both groups were given a triple therapy consisting of pantoprazole 40 mg for 2 weeks plus amoxicillin 1 g tris in die (t.i.d), and clarithromycin 250 mg t.i.d, for the first week of treatment. Eradication was confirmed by the (13)C-urea breath test at 3 months.
  
  
  RESULTS
  Successful eradication was observed in 55.0% of the overweight/obese group compared with 85.4% [p < 0.005; odds ratio (OR): 4.77; 95% confidence interval (CI): 1.64-13.87]. The distribution of age, gender, and smoking, as well as the proportion with corpus predominant gastritis (41.4% and 35.0% in control and overweight/obese groups, respectively), did not differ significantly between the two groups. Regression analysis showed that risk factors for treatment failure were BMI (p < 0.02) with an OR of 1.06 (95% CI: 1.01-1.11) and corpus-predominant gastritis (p < 0.001) with an OR of 8.74 (95% CI: 2.48-30.8).
  
  
  CONCLUSIONS
  Overweight/obese nondiabetic patients showed a significantly lower rate of eradication rate of H. pylori infection than controls. BMI and corpus-predominant gastritis appear to be independent risk factors for eradication failure.
authors.affiliation: Gastrointestinal Unit, Department of Clinical Sciences, University La Sapienza, Viale del Policlinico, 00161, Rome, Italy.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdullahi
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
authors.forename: Danila
authors.initials: D
authors.lastname: Capoccia
authors.forename: Roberto
authors.initials: R
authors.lastname: Tari
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.forename: John
authors.initials: J
authors.lastname: Osborn
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti
authors.forename: Carola
authors.initials: C
authors.lastname: Severi
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D015992:Body Mass Index; D017291:Clarithromycin / Q000008:administration & dosage; D015897:Comorbidity; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D016480:Helicobacter pylori; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000453:epidemiology; D000077402:Pantoprazole; D010865:Pilot Projects
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D000077402:Pantoprazole; D017291:Clarithromycin