Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients.

Michael Doulberis,Aristomenis K Exadaktylos,Jolanta Klukowska-Rötzler,Giulia Manzini,Simone Srivastava,David S Srivastava,Noah Thierry Pierre,Apostolis Papaefthymiou,Stergios A Polyzos,Thomas Kuntzen,Jürg Knuchel,Jannis Kountouras

doi:10.3390/microorganisms9071361

Michael Doulberis, Aristomenis K Exadaktylos + Show 10 more

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https://doi.org/10.3390/microorganisms9071361

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Abstract

Obesity, as a major risk factor of metabolic syndrome (MetS), represents a pandemic, especially in Western societies, and is considered a risk factor for malignancies. Helicobacter pylori (Hp), is a definite carcinogen with global distribution. We aimed to investigate, for the first time in Switzerland, the main gastric mucosa premalignant histological lesions of bariatric patients in correlation with MetS components and Hp Infection (Hp-I). By reviewing retrospectively 94304 patient cases, a total of 116 eligible patients having undergone bariatric surgery were identified. The mean patient age was 48.66 years. Hp(+) patients were 24% (28/116). Presence of gastric mucosa atrophy was documented in 8/28 Hp(+) patients (29%) and (2/88) Hp(−) ones (2%) (p = 0.006). Gastric mucosa intestinal metaplasia was observed in 14/28 (50%) Hp(+) patients versus 3/88 (3.4%) of Hp(-) group (p < 0.0001). Hp(+) patients exhibited statistically higher arterial hypertension (p = 0.033). The homeostatic model of assessment insulin resistance was also statistically significantly higher for the Hp(+) group (p < 0.001). In a multivariate analysis, including arterial hypertension, gastric mucosa atrophy, and intestinal metaplasia as variables, statistical significance remained only for intestinal metaplasia (p = 0.001). In conclusion, Hp-I is associated with premalignant gastric mucosa histologic lesions and MetS components, including arterial hypertension and IR. Further large-scale prospective studies are required to confirm these findings.

Highlights

We aimed to investigate, for the first time in Switzerland, the presence of the mentioned main histological precancerous lesions in gastric mucosa biopsies obtained in terms of a planned bariatric surgery and correlate them with a variety of metabolic parameters through the prism of Helicobacter pylori (Hp)-I
We demonstrated a Hp-I prevalence for Switzerland of about 24%, which is in line with previous studies of us [14] and others [34] reporting a prevalence of around 20%
As early as 2011, we reported an association between Hp-I and insulin resistance (IR) within a systematic review [52]

Summary

Introduction

Obesity has been associated with an elevated risk of various cancers including upper and lower gastrointestinal tract malignancies [4,5]. In this respect, Helicobacter pylori (Hp), a Gram-negative microaerophilic bacterium that colonizes primarily the stomach of more than 50% of people of the world has been characterized by the World Health Organization since 1994 as a class I (definitive) carcinogen [6,7]. Hp has been well established to cause gastritis [8,9], and up to 3% of the infected individuals develop gastric cancer (GC) and/or MALT lymphoma [10]. Hp-infection (Hp-I) is causally related to the development of gastric mucosa atrophic gastritis (AG) and intestinal metaplasia (IM), as well as GC [11,12]

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Discussion

Conclusion