Asymptomatic Helicobacter Pylori Infection in Preschool Children and Young Women Does Not Predict Iron Bioavailability from Iron-Fortified Foods.

Simone Buerkli,Diego Moretti,Michael B Zimmermann,Colin I Cercamondi,Ndèye Fatou Ndiaye,Isabelle Herter-Aeberli

doi:10.3390/nu11092093

Simone Buerkli, Diego Moretti + Show 4 more

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https://doi.org/10.3390/nu11092093

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Journal: Nutrients	Publication Date: Sep 4, 2019
Citations: 9	License type: CC BY 4.0

Affiliation: ETH Zurich, Cheikh Anta Diop University

Abstract

Helicobacter pylori infection is common in low-income countries. It has been associated with iron deficiency and reduced efficacy of iron supplementation. Whether H. pylori infection affects iron absorption from fortified and biofortified foods is unclear. Our objective was to assess whether asymptomatic H. pylori infection predicts dietary iron bioavailability in women and children, two main target groups of iron fortification programs. We did a pooled analysis of studies in women of reproductive age and preschool children that were conducted in Benin, Senegal and Haiti using stable iron isotope tracers to measure erythrocyte iron incorporation. We used mixed models to assess whether asymptomatic H. pylori infection predicted fractional iron absorption from ferrous sulfate, ferrous fumarate or NaFeEDTA, controlling for age, hemoglobin, iron status (serum ferritin), inflammation (C-reactive protein), and test meal. The analysis included 213 iron bioavailability measurements from 80 women and 235 measurements from 90 children; 51.3% of women and 54.4% of children were seropositive for H. pylori. In both women and children, hemoglobin (Hb), serum ferritin (SF), and C-reactive protein (CRP) did not differ between the seropositive and seronegative groups. Geometric mean (95% CI) fractional iron absorption (%), adjusted for SF, was 8.97% (7.64, 10.54) and 6.06% (4.80, 7.67) in H. pylori positive and negative women (p = 0.274), and 9.02% (7.68, 10.59) and 7.44% (6.01, 9.20) in H. pylori positive and negative children (p = 0.479). Our data suggest asymptomatic H. pylori infection does not predict fractional iron absorption from iron fortificants given to preschool children or young women in low-income settings.

Highlights

Helicobacter pylori (H. pylori) is a common colonizer of the human gastric mucus [1]
A systematic review of studies conducted in adults and children, concluded that H. pylori infection increases the risk for low iron status
Data on iron bioavailability from 11 different test meals were included for women and data from 13 different test meals for children; the analysis included a total of 213 iron bioavailability measures in women and 232 measures in children

Summary

Introduction

Helicobacter pylori (H. pylori) is a common colonizer of the human gastric mucus [1]. It is estimated that ≈50% of the global population may be infected [2], and prevalence is higher in low income countries, ranging from 65% in adults from Thailand [3] and Ethiopia [4] to 85% in mothers from. Infection with H. pylori usually begins during childhood and may have lifelong persistence if not treated; in Bangladesh prevalence range from 47% in children below the age of 2 [5], 60% in children less than 5 years-old [6], up to 93% prevalence in children below the age of 15 [7]. Infection with H. pylori is a major risk factor for chronic gastritis, peptic ulcer disease, and gastric cancer, the majority of cases remain asymptomatic [2]. A systematic review of studies conducted in adults and children, concluded that H. pylori infection increases the risk for low iron status. The meta-analysis reported a 1.33 odds ratio for iron deficiency (ID)

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