PLoS ONE (Jan 2013)

Iron status and Helicobacter pylori infection in symptomatic children: an international multi-centered study.

  • Dulciene Maria Magalhaes Queiroz,
  • Paul R Harris,
  • Ian R Sanderson,
  • Henry J Windle,
  • Marjorie M Walker,
  • Andreia Maria Camargos Rocha,
  • Gifone Aguiar Rocha,
  • Simone Diniz Carvalho,
  • Paulo Fernando Souto Bittencourt,
  • Lucia Porto Fonseca de Castro,
  • Andrea Villagrán,
  • Carolina Serrano,
  • Dermot Kelleher,
  • Jean E Crabtree

DOI
https://doi.org/10.1371/journal.pone.0068833
Journal volume & issue
Vol. 8, no. 7
p. e68833

Abstract

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OBJECTIVE: Iron deficiency (ID) and iron deficiency anaemia (IDA) are global major public health problems, particularly in developing countries. Whilst an association between H. pylori infection and ID/IDA has been proposed in the literature, currently there is no consensus. We studied the effects of H. pylori infection on ID/IDA in a cohort of children undergoing upper gastrointestinal endoscopy for upper abdominal pain in two developing and one developed country. METHODS: In total 311 children (mean age 10.7±3.2 years) from Latin America--Belo Horizonte/Brazil (n = 125), Santiago/Chile (n = 105)--and London/UK (n = 81), were studied. Gastric and duodenal biopsies were obtained for evaluation of histology and H. pylori status and blood samples for parameters of ID/IDA. RESULTS: The prevalence of H. pylori infection was 27.7% being significantly higher (p<0.001) in Latin America (35%) than in UK (7%). Multiple linear regression models revealed H. pylori infection as a significant predictor of low ferritin and haemoglobin concentrations in children from Latin-America. A negative correlation was observed between MCV (r = -0.26; p = 0.01) and MCH (r = -0.27; p = 0.01) values and the degree of antral chronic inflammation, and between MCH and the degree of corpus chronic (r = -0.29, p = 0.008) and active (r = -0.27, p = 0.002) inflammation. CONCLUSIONS: This study demonstrates that H. pylori infection in children influences the serum ferritin and haemoglobin concentrations, markers of early depletion of iron stores and anaemia respectively.