D vitamini düzeylerinin Helicobacter pylori eradikasyon oranlarına etkisi

Year 2024, Volume: 6 Issue: 1, 28 - 32, 26.02.2024

Güner Kılıç , Gulce Ecem Kilic , Adnan Özkahraman , Şevki Konür , Yusuf Kayar

https://doi.org/10.52827/hititmedj.1332272

Abstract

Amaç: H. pylori eradikasyonunda birçok faktörün rol oynadığı bilinmektedir. Bu çalışmanın amacı H. pylori'nin eradikasyon başarısına 25(OH) D vitamininin etkisini araştırmaktır.
Gereç ve Yöntem: Bu retrospektif çalışmaya Gastroenteroloji Polikliniğine en az 6 aydır devam eden dispeptik yakınmalarla başvuran 18-85 yaş arası 237 hasta dahil edildi. Hastalar 25(OH) vitamin D düzeyine göre >20ng/ml ve <20ng/ml olmak üzere iki gruptan ayrıldı. Hp eradikasyonu için hastalara gemifloksasin 320 mg 1x1 , amoksisilin 1 gr 2x1 ve rabeprazol 40 mg 1x1 tedavileri verildi. Tedaviden 1 ay sonra Hp'nin eradike edilip edilmediğinin tespiti için dışkı incelemesi yapıldı. D vitamini seviyesi yüksek ve düşük olan gruplar arasında eradikasyon oranları karşılaştırıldı.
Bulgular: Hastaların 139'u (%58,6) kadın, 98'i (%41,4) erkekti ve ortalama yaşları 40,9±14,1 (18-72 yaş arası) idi. D vitamini düzeyi ortalama 16,3±8,4 (3-42) olarak saptandı. 211 (%89,0) hastada yetersiz düzeyde görülmüştür. Gruplar arası D vitamini düzeyleri karşılaştırıldığında, Hp eradikasyonu yapılan grupta D vitamini düzeyi 16,8±8,5, Hp eradikasyonu yapılmayan grupta ise 12,7±6,5 olarak belirlendi.İki grup arasındaki fark istatistiki olarak anlamlı bulundu (p=0,018).
Sonuç: Hp eradikasyon tedavisi öncesinde, eradikasyonun etkinliğini etkileyen D vitamini düzeylerinin optimum düzeyde tutulması önemlidir.

Keywords

Eradikasyon, Helicobacter pylori, D vitamini

Project Number

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The effect of vitamin D levels on eradication rates of Helicobacter pylori infection

Abstract

Objective: Many factors are known to play a role in the eradication of Helicobacter pylori (Hp). The aim of this study is to investigate the effect of 25(OH) vitamin D levels on the success of H. pylori eradication.
Material and Method: This retrospective study included 237 patients, aged 18-85 years, who presented at the Gastroenterology Polyclinic with dyspeptic complaints which had been ongoing for at least 6 months. Patients were divided into two groups according to their 25(OH) vitamin D level as >20ng/ml and <20ng/ml. For Hp eradication, the patients were administered treatment of 1x1 320 mg gemifloxacin, 2x1 1 gr amoxicillin, and 1 x1 40 mg rabeprazole. After 1 month of treatment, faecal examination was made to determine whether or not Hp was eradicated. The eradication rates were compared between the groups with high and low level 25(OH) vitamin D.
Results: The patients comprised 139 (58.6%) females and 98 (41.4%) males with a mean age of 40.9±14.1 years (range, 18-72 years). The 25(OH) vitamin D level was determined as mean 16.3±8.4 ng/mL (range, 3-42) in the whole sample, with an insufficient level seen in 211(89.0%) patients. In the comparison of 25(OH) vitamin D levels between the groups, the 25(OH) vitamin D level was determined to be 16.8±8.5 in the group with Hp eradication and 12.7±6.5 in the group without Hp eradication. The difference between the two groups was found to be statistically significant (p= 0.018).
Conclusion: Before H pylori eradication treatment, it is important to maintain optimal levels of 25(OH) vitamin D, which has an effect on the effectiveness of eradication.

Keywords

eradication, helocobacter pylori, vitamin D

Supporting Institution

none

Project Number

-

Thanks

none

References

• Hu Y, Zhu Y, Lu N-H. Recent progress in Helicobacter pylori treatment. Chinese Medical Journal. 2020;133(03):335-43.
• Bener A, Uduman S, Ameen A, Alwash R, Pasha M, Usmani M, et al. Prevalence of Helicobacter pylori infection among low socio-economic workers. The Journal of Communicable Diseases. 2002;34(3):179-84.
• Malfertheiner P, Link A, Selgrad M. Helicobacter pylori: perspectives and time trends. Nature reviews Gastroenterology & hepatology. 2014;11(10):628-38.
• Zimmerman J, Arnon D, Beeri R, Keret D, Lysy J, Ligumski M, et al. Seasonal Fluctuations in Acute Upper Gastrointestinal Bleeding: Lack of Effect of Nonsteroidal Anti--inflammatory Drugs. American Journal of Gastroenterology (Springer Nature). 1992;87(11).
• Uotani T, Miftahussurur M, Yamaoka Y. Effect of bacterial and host factors on Helicobacter pylori eradication therapy. Expert opinion on therapeutic targets. 2015;19(12):1637-50.
• de Brito BB, da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM, et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World journal of gastroenterology. 2019;25(37):5578.
• Antico, Antonio, et al. "Hypovitaminosis D as predisposing factor for atrophic type A gastritis: a case–control study and review of the literature on the interaction of vitamin D with the immune system." Clinical reviews in allergy & immunology 42 (2012): 355-364.
• Huang, Bin, et al. "Effect of 25-hydroxyvitamin D on Helicobacter pylori eradication in patients with type 2 diabetes." Wiener Klinische Wochenschrift 131 (2019): 75-80.
• Zhang, Ye, et al. "Vitamin D3 eradicates Helicobacter pylori by inducing VDR-CAMP signaling." Frontiers in Microbiology 13 (2022): 1033201.
• Shatla, Mokhtar M., Ahmed S. Faisal, and Mahmoud Z. El-Readi. "Is vitamin D deficiency a risk factor for Helicobacter pylori eradication failure?." Clinical Laboratory 2 (2021).
• Assaad, Shafika, et al. "Dietary habits and Helicobacter pylori infection: a cross sectional study at a Lebanese hospital." BMC gastroenterology 18 (2018): 1-13.
• Zhang, Mei. "High antibiotic resistance rate: A difficult issue for Helicobacter pylori eradication treatment." World journal of gastroenterology 21.48 (2015): 13432.
• Guo L, Chen W, Zhu H, Chen Y, Wan X, Yang N, et al. H elicobacter pylori induces increased expression of the vitamin D receptor in immune responses. Helicobacter. 2014;19(1):37-47.
• Zhou, Anni, et al. "Vitamin D3 inhibits helicobacter pylori infection by activating the VitD3/VDR-CAMP pathway in mice." Frontiers in Cellular and Infection Microbiology 10 (2020): 566730.
• Izquierdo MJ, Cavia M, Muñiz P, de Francisco AL, Arias M, Santos J, et al. Paricalcitol reduces oxidative stress and inflammation in hemodialysis patients. BMC nephrology. 2012;13(1):1-7.
• Hu, Wei, et al. "Vitamin D3 activates the autolysosomal degradation function against Helicobacter pylori through the PDIA3 receptor in gastric epithelial cells." Autophagy 15.4 (2019): 707-725.
• Li, Mingxing, et al. "1, 25-Dihydroxyvitamin D3 suppresses gastric cancer cell growth through VDR-and mutant p53-mediated induction of p21." Life Sciences 179 (2017): 88-97.
• Shafrir A, Shauly-Aharonov M, Katz LH, Paltiel O, Pickman Y, Ackerman Z. The association between serum vitamin D levels and Helicobacter pylori presence and eradication. Nutrients. 2021;13(1):278.
• Yang, Liping, et al. "Effect of vitamin D on Helicobacter pylori infection and eradication: A meta‐analysis." Helicobacter 24.5 (2019): e12655.
• Shahawy, Mohamed S. EL, Zakarya M. Shady, and Abdullah Gaafar. "Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection." Arab Journal of Gastroenterology 22.3 (2021): 209-214.