Abstract
Background and Aim As a worldwide infectious bacterium, H. pylori leads to stomach pathologies such as gastritis, peptic ulcer, gastric cancer, MALToma, and various extragastric manifestations. In our study, we aimed to investigate the association between serum vitamin B12 level and cytotoxin-associated gene-A (CagA) seropositivity, which is one of the virulence factors of Helicobacter pylori (H. pylori). Method This study has been conducted on 289 patients who have met the inclusion criteria. Within these patients, 213 of them were H. pylori positive and 76 were negative. Vitamin B12 and CagA-IgG levels were assessed in consecutive dyspeptic patients undergoing upper endoscopy. Results Out of 289 patients, 51.9% were women (n = 150) and H. pylori was detected in 213 (73.7%) patients. Histopathological evaluation with modified Sydney classification revealed lymphocyte infiltration in 66.8% (n = 193), activation in 46% (n = 133), metaplasia in 11.4% (n = 33), atrophy in 11.4% (n = 33), and lymphoid follicles in 21.1% (n = 61) of the patients. Within H. pylori-positive patients, the ratio of CagA positivity was 57.3% (n = 122). Low B12 vitamin level was significantly correlated with existence of H. pylori (p=0.02), CagA (p=0.002), lymphocyte (p=0.006), metaplasia (p=0.001), atrophy (p=0.001), and lymphoid follicles (p=0.006). Positivity of CagA has been detected to be statistically corelated with lymphocyte (p=0.001) and activation (p=0.005); however, the same relation was not present with atrophy (p=0.236). Conclusion In conclusion, B12 deficiency was positively correlated with CagA positivity and gastric inflammatory activity.
Highlights
Introduction and AimHelicobacter pylori (H. pylori) is present in almost 50% of the world’s population [1], while in western world it is up to 20% and about 90% in developing countries [2, 3]
We aimed to investigate the association between serum vitamin B12 level and cytotoxin-associated gene-A (CagA) seropositivity, which is one of the virulence factors of Helicobacter pylori (H. pylori)
We aimed to investigate the association between serum B12 vitamin level and presence of virulence factor cytotoxin-associated gene-A (CagA) seropositivity to clarify the relation with the type of histological damage whether it is atrophy or inflammation
Summary
Helicobacter pylori (H. pylori) is present in almost 50% of the world’s population [1], while in western world it is up to 20% and about 90% in developing countries [2, 3] It is a Gram (− ), unipolar, spiral or curved, mobile, rounded tip, with 4–6 flagella, microaerophilic, and sausage-like bacteria. We aimed to investigate the association between serum B12 vitamin level (tested in patients as a part of dyspepsia investigation) and presence of virulence factor cytotoxin-associated gene-A (CagA) seropositivity to clarify the relation with the type of histological damage whether it is atrophy or inflammation. 2. Materials and Methods e patients investigated with upper gastrointestinal endoscopy due to dyspepsia were analysed for their data of demographic, clinical, endoscopic, and histopathological findings and levels of vitamin B12 and CagA IgG. All authors had access to the study data and reviewed and approved the final manuscript
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