title: The effect of H. pylori eradication on meal-associated changes in plasma ghrelin and leptin.
abstract: BACKGROUND
  Appetite and energy expenditure are regulated in part by ghrelin and leptin produced in the gastric mucosa, which may be modified by H. pylori colonization. We prospectively evaluated the effect of H. pylori eradication on meal-associated changes in serum ghrelin and leptin levels, and body weight.
  
  
  METHODS
  Veterans referred for upper GI endoscopy were evaluated at baseline and ≥8 weeks after endoscopy, and H. pylori status and body weight were ascertained. During the first visit in all subjects, and during subsequent visits in the initially H. pylori-positive subjects and controls, blood was collected after an overnight fast and 1 h after a standard high protein meal, and levels of eight hormones determined.
  
  
  RESULTS
  Of 92 enrolled subjects, 38 were H. pylori-negative, 44 H. pylori-positive, and 10 were indeterminate. Among 23 H. pylori-positive subjects who completed evaluation after treatment, 21 were eradicated, and 2 failed eradication. After a median of seven months following eradication, six hormones related to energy homeostasis showed no significant differences, but post-prandial acylated ghrelin levels were nearly six-fold higher than pre-eradication (p=0.005), and median integrated leptin levels also increased (20%) significantly (p<0.001). BMI significantly increased (5 ± 2%; p=0.008) over 18 months in the initially H. pylori-positive individuals, but was not significantly changed in those who were H. pylori-negative or indeterminant at baseline.
  
  
  CONCLUSIONS
  Circulating meal-associated leptin and ghrelin levels and BMI changed significantly after H. pylori eradication, providing direct evidence that H. pylori colonization is involved in ghrelin and leptin regulation, with consequent effects on body morphometry.
authors.affiliation: New York University Langone Medical Center, New York, NY, USA. Fritz.francois@med.nyu.edu
authors.forename: Fritz
authors.initials: F
authors.lastname: Francois
authors.forename: Jatin
authors.initials: J
authors.lastname: Roper
authors.forename: Neal
authors.initials: N
authors.lastname: Joseph
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Pei
authors.forename: Aditi
authors.initials: A
authors.lastname: Chhada
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Shak
authors.forename: Asalia Z Olivares
authors.initials: AZ
authors.lastname: de Perez
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015992:Body Mass Index; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005502:Food; D054439:Ghrelin / Q000097:blood*; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D054439:Ghrelin; D020738:Leptin; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin