The eradication of Helicobacter pylori is affected by body mass index (BMI).
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.
Abdullahi
Mohamed
M
Gastrointestinal Unit, Department of Clinical Sciences, University La Sapienza, Viale del Policlinico, 00161, Rome, Italy.
Annibale
Bruno
B
Capoccia
Danila
D
Tari
Roberto
R
Lahner
Edith
E
Osborn
John
J
Leonetti
Frida
F
Severi
Carola
C
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
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D000077402:Pantoprazole; D017291:Clarithromycin