Does H. pylori Colonization Impact Basal Metabolic Rate?

Abstract

Introduction: Ghrelin is produced mainly by the stomach and may influence energy expenditure. H. pylori colonization is associated with reduced circulating ghrelin levels. We hypothesized that H. pylori colonization impacts resting metabolic rate (RMR). The aims of this study were to: 1.) evaluate the reproducibility of RMR measurements via a hand-held indirect calorimeter in healthy young adults, 2.) compare the RMR between individuals with and without H. pylori colonization, and 3.) analyze the change in RMR after H. pylori eradication. Methods: For the validation aim of the study, 7 healthy volunteers were enrolled and evaluated for demographic as well as clinical information. The MedGem indirect calorimeter device was used for all measurements. Weekly-standardized RMR and oxygen consumption (VO2) measurements were obtained for 4 consecutive weeks. For the second and third aims, 44 participants were evaluated at baseline for H. pylori status. All H. pylori-positive participants were treated with standard eradication regimens. RMR data was collected at baseline and subsequent follow-up visits (6 weeks, 3 months, and 6 months). Results: For the validation aim of the study, the pairwise correlations for weekly RMR measurements were all higher than 0.70, and the intra-class correlation coefficient (ICC) of the multiple measurements of RMR was 0.987 over 4 weeks. For the second and third aims, 17% of all participants were male, and the mean age was 24.57 years. The mean baseline BMI for all participants was 24.03. The mean baseline RMR for the H. pylori-negative and positive participants was 1297.8 and 1421.4, respectively. There was no significant difference in baseline RMR by H. pylori status (p=0.631). The absolute mean change in RMR from baseline to 6 weeks post treatment was greater for the H. pylori-positive group than the negative group (18.6 vs. -2.5), although not statistically significant. Similarly, the mean change in RMR from baseline to 3 months post treatment was greater for the H. pylori-positive group than the negative group (75.0 vs. 62.5). For the H. pylori-positive group, there was a significant difference between the mean RMR at baseline compared to the 3-month follow-up (p=0.034). Conclusion: Measurement of resting metabolic rate via a hand-held indirect calorimeter in young healthy adults is reproducible. H. pylori-colonization, as well as eradication, impacts RMR. Further assessment of the long-term metabolic consequences of H. pylori eradication should be undertaken.