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Helicobacter pylori and type 1 diabetes mellitus in children
S Salardi1, E Cacciari, M Menegatti
1First Pediatric Clinic, University of Bologna, Italy.
Insights
Children with type 1 diabetes may have a higher risk of Helicobacter pylori infection over time. This common childhood infection could contribute to gastritis in those with long-standing diabetes.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Gastroenterology
Background:
- Helicobacter pylori is a common bacterial pathogen causing gastroduodenal issues.
- H. pylori infection is typically acquired in childhood.
- Diabetes mellitus is associated with increased susceptibility to infections.
Purpose of the Study:
- To compare H. pylori infection prevalence and specific virulence factors (CagA, VacA) in children with and without type 1 diabetes.
- To investigate the relationship between H. pylori infection and disease duration in diabetic children.
Main Methods:
- A Recombinant ImmunoBlot Assay-Strip (RIBA SIA) was used to detect H. pylori, CagA, and VacA antibodies.
- The study included 103 children and adolescents with type 1 diabetes and 236 non-diabetic controls.
Main Results:
- H. pylori positivity was higher in diabetic patients compared to controls, particularly for whole lysate reactivity.
- Older diabetic patients (over 12 years) with longer disease duration showed a trend towards higher H. pylori prevalence.
- Age was a significant factor, with H. pylori-positive individuals being older in both groups.
Conclusions:
- Diabetic children initially show similar H. pylori prevalence to non-diabetic peers.
- Over time, diabetic children may exhibit a tendentially higher H. pylori seroprevalence.
- Chronic H. pylori infection acquired in childhood may contribute to chronic atrophic gastritis, which is more common in long-standing diabetes.
Background:
Helicobacter pylori is a recognized gastroduodenal pathogen and H. pylori infection is one of the most common bacterial infections, usually acquired during childhood. However, diabetes mellitus is characterized by an increased susceptibility to infections.
Methods:
We compared the prevalence of H. pylori infection as well as cytotoxin-associated gene A-CagA-and vacuolating cytotoxin gene A-VacA-positivity in 103 children and adolescents with type 1 diabetes mellitus and in 236 nondiabetic children. We used a novel Recombinant ImmunoBlot Assay-Strip (RIBA SIA) with individual band for whole H. pylori lysate and recombinant CagA and VacA.
Results:
H. pylori-positive subjects, both diabetics and controls, were significantly older than negative subjects. In the whole group of diabetic patients the prevalence of each of the three reactivities was higher than in control subjects, reaching significance only for lysate. Only diabetic patients over 12 years of age, with a longer disease duration, had a higher prevalence of positive cases, although not significantly so.
Conclusions:
In the first few years of disease, diabetic children do not differ from the nondiabetic population. Subsequently they show an H. pylori seroprevalence tendentially higher than that of controls of the same age. Therefore, H. pylori infection acquired in childhood and lasting several years, could be one of the causes of chronic atrophic gastritis, which is more frequent in longstanding diabetes mellitus.