Nutritional status of iron, zinc and copper in Helicobacter pylori infected children from Buenos Aires, Argentina. Its relationship with bacterial genotype.

JANJETIC M; GOLDMAN C; BARRADO A; FUDA J; MESERI E; FURNO J; TORI H; BELTRÁN GONZÁLEZ A; CUETO RUA E; BALCARCE N; ZUBULLAGA M; BOCCIO J

Beijing

Congreso; The 2nd International Meeting of the Micronutrient Forum.; 2009

Micronutrient Forum Program Committee and Chinese Center for Disease Control and Prevention

Background: Helicobacter pylori infection is the mayor etiologic factor in the development of chronic gastritis and peptic ulcer disease. H. pylori have been related to iron deficiency anemia (IDA) and other micronutrient deficiences. Clinical outcome of the infection was reported to b influenced by bacterial virulence genes CagA and VacA, among other factors. However the role of H. pylori genotype in the development of micronutrient deficiencies has not been established. To determine the prevalence of H. pylori infection in symptomatic children from Buenos Aires, Argentina, and to evaluate the relationship between bacterial genotype and iron, copper and zinc nutritional status. A total of 395 children referred with upper gastrointestinal symptoms were evaluated for the presence of H. pylori by the 13 U-Urea Breath Test. Bacterial genotype war determined from gastric biopsies specimens. Copper and zinc serum levels were measured by atomic absorption spectrometry, serum ferritine levels (SF) by an inmunoreactive assay and hemoglobin by an automatic hematological counter. Iron deficiency (ID) was defined by ferritin values < 15 µg/L, and anemia by hemoglobin values 11.5-12 g/dL, according to age. Soluble transferrine receptors (TfR) were evaluated as a measure of functional iron deficiency. H. pylori CagA/VacA genotype was evaluated by Polymerase Chain Reaction. Statistical analysis was performed by Linear and Logistic regression, the Fischer Test, Student ‘ s test and Mann Whitney Test. Results: A total of 96 children (24.3%) were H.pylori positive. ID was observed in 14.3% and 11.0 %. in the H. pylori positive group. Prevalence of anemia was 12.0% for the positives , and 8.9% for the negatives. No association was found between H. pylori infection and anemia, nevertheless H. pylori infected children had a decrease of 9.69 µg/L (95% IC; -17.57 to -1.80) in serum ferritin levels compared to non-infected children However no association was found between H. pylori infection and TfR. Nutritional status of zinc was not associated to H. pylori positivity, although H. pylori infected children had an increase of 9.69 µg/dL (95% CI; 1.97 to 17.43) in copper levels compared to non-infected children. H. pylori genotype was distributed as follows:55.2% VacA s1/CagA+ , 17.9% Vac s1/CagA- and 26.9% VacA s2/CagA- . No association was found between H. pylori genotype and ID (p=0.71), anemia (p=0.14), serum zinc (p=0.4) and copper levels (p=0.13). H. pylori infection was associated to low ferritine and higher copper levels, although bacterial genotype was not involved in this relationship.