Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 93, Issue 6, Pages 2350-2357Publisher
ENDOCRINE SOC
DOI: 10.1210/jc.2007-2057
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Funding
- NCI NIH HHS [K23 CA107123, R01 CA097946, R01 CA 97946, K23 CA 107123] Funding Source: Medline
- NIGMS NIH HHS [R01 GM 63270, R01 GM063270] Funding Source: Medline
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Context: Leptin and ghrelin, hormones involved in human energy homeostasis, are both produced in the stomach. Objective: We sought to determine whether the presence of Helicobacter pylori affects gastric and systemic levels of leptin and ghrelin. Design, Setting, and Patients: We consecutively enrolled 256 patients referred for upper endoscopy at a Veterans Affairs outpatient endoscopy center. Outcomes: We obtained fasting serum, fundic and antral biopsies, and gastric juice. Based on histological, biochemical, and serological assays, patients were categorized as H. pylori+ or H. pylori-. Leptin and total ghrelin levels in serum, gastric biopsies, and gastric juice were determined by specific ELISAs. Results: Of the 256 subjects, 120 were H. pylori+ and 96 were H. pylori-; 40 patients of indeterminate status were excluded. Serum and fundic leptin levels correlated with body mass index in the H. pylori+(r = 0.35; P < 0.0001 and r = 0.35; P < 0.0001, respectively) and H. pylori-(r = 0.65; P < 0.0001 and r = 0.41; P < 0.0001, respectively) groups, but H. pylori+ subjects had significantly lower serum leptin levels [median 2.2 ng/ml (interquartile range 0.9-4.6) vs. 4.0 ng/ml (1.7-7.2); P < 0.0003]. Serum ghrelin levels were similar in the H. pylori+ and H. pylori- groups [median 1651 pg/ml (interquartile range 845-2247) vs. 1629 pg/ml (992-2886); P = 0.23]. H. pylori status did not significantly affect gastric biopsy leptin and ghrelin levels. Ghrelin levels in gastric juice varied over 4log(10) (< 80-776,000 pg/ml) and correlated with gastric juice pH in the H. pylori+ group (r = 0.68; P < 0.0001). Conclusions: These findings provide evidence that H. pylori status affects leptin and ghrelin homeostasis, presumably via intragastric interactions.
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