title: Helicobacter pylori Infection in Children: Nutritional Status and Associations with Serum Leptin, Ghrelin, and IGF-1 Levels.
abstract: BACKGROUND
  Helicobacter pylori is associated with gastrointestinal diseases such as gastritis, peptic ulcers, malignancy and lymphoma, and extra-gastrointestinal conditions. H. pylori infection is negatively associated with children's growth. Chronic inflammation of the stomach that results in the loss of appetite and, dysregulation of neuroendocrine hormones such as leptin, and ghrelin are the probable reasons of this negative association. The objective of this study is to determine the serum levels of leptin, ghrelin, and IGF-1 in H. pylori-infected children and their relations with growth.
  
  
  METHODS
  A hundred and sixty-one school children aged between 6 and 14 years were selected randomly from five primary schools representing a cross section of population. Demographic and sociocultural characteristics, and anthropometric measurements were recorded. Serum H. pylori IgG, insulin-like growth factor-1, leptin, and ghrelin levels were measured in all children. The children were grouped according to the nutritional status and Helicobacter pylori seropositivity. Nutritional indices were compared among groups in association with serum leptin, ghrelin, and insulin-like growth factor-1 levels.
  
  
  RESULTS
  H. pylori IgG positivity was found in 34.2%, and 14.9% of children were malnourished. H. pylori seropositivity was significantly higher in older ages (10.32 ± 2.26 vs 9.53 ± 2.36 years, p = .036), and body weight and height Z scores were significantly lower in H. pylori-seropositive children (-0.33 ± 1.08 vs 0.04 ± 1.26, p = .044 and 0.13 ± 0.92 vs 0.23 ± 0.91, p = .018 respectively). H. pylori seropositivity was found to be an independent risk factor for shorter body height (p = .01). Serum leptin, ghrelin, and IGF-1 levels were not associated with H. pylori IgG seropositivity (0.35 vs 0.55 ng/mL, p = .3; 3267.4 ± 753.0 vs 2808.3 ± 911.4 pg/mL, p = .06; 470 ± 176 vs 521 ± 179 ng/mL, p = .32, respectively).
  
  
  CONCLUSIONS
  Children infected with H. pylori are prone to short stature. This effect seems to be independent of neuroendocrine hormones.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Gulin
authors.initials: G
authors.lastname: Erdemir
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Tanju Basarir
authors.initials: TB
authors.lastname: Ozkan
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Ozgur
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Altay
authors.affiliation: Department of Medical Pharmacology, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Cavun
authors.affiliation: Department of Microbiology, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Guher
authors.initials: G
authors.lastname: Goral
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D002648:Child; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D054439:Ghrelin / Q000097:blood*; D016481:Helicobacter Infections / Q000453:epidemiology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D020738:Leptin / Q000097:blood*; D008297:Male; D009752:Nutritional Status; D012574:Schools; D044967:Serum / Q000737:chemistry*; D013334:Students
chemical_list: D054439:Ghrelin; D020738:Leptin; D007334:Insulin-Like Growth Factor I
keywords: Childhood; H. pylori; ghrelin; growth; leptin