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Helicobacter pylori infection with iron deficiency anaemia and subnormal growth at puberty
1Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, 7-206, 3-Ga, Shinheung-Dong, Jung-Gu, Inchon 400-103, Korea. yhchoe@dragon.inha.ac.kr
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Helicobacter pylori infection combined with iron deficiency anemia may stunt growth in children. The study found that children with both conditions had significantly lower heights, suggesting a synergistic effect on pubertal growth.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Nutritional Science
Background:
- Pubescent children require substantial iron for growth.
- Helicobacter pylori (H pylori) infection is a common gastrointestinal pathogen.
- The link between H pylori infection and growth deficits, particularly in relation to iron status, requires further investigation.
Purpose of the Study:
- To investigate the association between Helicobacter pylori infection and growth deficit in pubescent children.
- To determine if H pylori infection contributes to growth delay, especially in children with iron deficiency.
Main Methods:
- A cross-sectional study involving 375 healthy children aged 10-15 years.
- Data collection included questionnaires, blood samples for iron status (hemoglobin, serum iron, ferritin) and H pylori IgG antibodies.
- Multiple regression analysis was used to assess the impact of risk factors on growth.
Main Results:
- H pylori infection prevalence was 15.5% in children without iron deficiency anemia and 31.3% in those with it.
- Children with H pylori infection showed a slightly higher rate of short stature (28.6% vs 20.2%).
- The combination of H pylori infection and iron deficiency anemia was associated with significantly lower mean height.
Conclusions:
- H pylori infection alone does not appear to significantly impact pubertal growth.
- The synergistic effect of H pylori infection and iron deficiency anemia may contribute to growth deficits in children.
- Further research is warranted to elucidate the mechanisms behind this combined effect.
Abstract:
The purpose of this study was to determine whether Helicobacter pylori infection can contribute to growth deficit, especially in pubescent children who need large amounts of iron for growth. A structured questionnaire was sent to the parents of 532 healthy children aged 10 to 15 years (mean 12.9) to obtain demographic information on the parents and the environment. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. After collecting blood samples from participants, haemoglobin, serum iron, total iron binding capacity, serum ferritin, and serum IgG antibodies to H pylori were measured. The effects of risk factors such as H pylori infection, iron deficiency anaemia, sex, socioeconomic status, type of house, and crowding index on growth were analysed using multiple regression analysis. Of 63 H pylori positive children, 18 (28.6%) were below the 25th centile values for height, compared with 63 of 312 (20.2%) H pylori negative children. The prevalence rate of H pylori infection was 15.5% (53 of 343) in children without iron deficiency anaemia and 31.3% (10 of 32) in those affected. The relative risk of short stature was 2.2 (95% confidence interval (CI), 1.0 to 4.8) for iron deficiency anaemia, and 1.4 (95% CI, 0.8 to 2.4) for H pylori infection. The mean height was significantly lower in the group having both H pylori infection and iron deficiency anaemia. Therefore, H pylori infection accompanied by iron deficiency anaemia, rather than H pylori infection per se, might delay pubertal growth.