Helicobacter pylori-associated iron-deficiency anemia in adolescent female athletes

Objective: The objective was to investigate the role of Helicobacter pylori infection in iron-deficiency anemia (IDA) of pubescent athletes. Study design: Blood sampling and a questionnaire survey were performed on 440 regular high school students and 220 athletes of a physical education high school. Hemoglobin, serum iron, total iron-binding capacity, ferritin, and immunoglobulin G antibody to H pylori were measured to compare the prevalence of IDA and H pylori infection in the groups. Nutritional analysis and a questionnaire survey for socioeconomic status were undertaken to compare and control for other risk factors that might influence IDA and H pylori infection in the groups. In those with IDA coexistent with H pylori infection, we also determined whether IDA can be managed by H pylori eradication. Results: The prevalence rates of IDA, H pylori infection, and H pylori-associated IDA in female athletes were higher than in the control group. The relative risk of IDA was 2.9 (95% CI, 1.5 to 5.6) for those with H pylori infection. Athletes who exhibited H pylori-associated IDA showed significant increases in hemoglobin, iron, and ferritin levels after H pylori eradication. The subjects in the control group who were treated orally with iron alone showed no significant changes. Conclusion: Adolescent female athletes may have development of H pylori-associated IDA, which can be managed by H pylori eradication.