Vitamin D status and Helicobacter pylori infection: clinical associations and lipid pathway differences in an
Said El Shamieh1, Mai Abdel Jabbar2, Rajaa Fakhoury1,2
1Molecular Testing Laboratory, Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Background:
Vitamin D has immunomodulatory functions, and lower serum levels have been associated with increased risk of chronic infections, including Helicobacter pylori. We evaluated the association between vitamin D status and H. pylori infection and explored vitamin D-associated metabolic differences in an exploratory untargeted metabolomics sub-study.
Methods:
This cross-sectional study enrolled 502 unrelated Lebanese adults (323 females, 179 males). Demographic, clinical, and biochemical variables were collected, including serum total 25-hydroxyvitamin D [25(OH)D] and serum iron levels. H. pylori infection was assessed by urea breath test or histology. Multivariable logistic regression was used to examine factors associated with H. pylori infection. Untargeted metabolomics was performed in an exploratory sub-study (n = 50) that included both H. pylori-positive and -negative participants, comparing vitamin D-deficient versus non-deficient individuals, followed by pathway enrichment analysis.
Results:
Vitamin D deficiency was more frequent among H. pylori-positive participants (p < 10-23), and mean serum iron level was lower among H. pylori-positive participants (78.39 μg/dL; p = 0.039). In multivariable analysis, compared with vitamin D deficiency, vitamin D insufficiency [OR = 0.11 (0.06-0.18), p = 2.58 × 10-14] and normal vitamin D status [OR = 0.02 (0.01-0.04), p = 4.35 × 10-23] were associated with lower odds of H. pylori infection; female sex was also associated with lower odds (OR = 0.44, 95% CI: 0.24-0.81; p = 0.01). In the metabolomics sub-study (n = 50), vitamin D deficiency was associated with differential metabolic features indicating altered lipid-related pathways, including sphingolipid (impact = 0.735; p adj = 2.07 × 10-6), glycerophospholipid (impact = 0.468; p adj = 0.005), and ether lipid metabolism (impact = 0.126; p adj = 0.010).
Conclusion:
Vitamin D deficiency was strongly and dose-dependently associated with H. pylori infection in this cohort. In the metabolomics sub-study, vitamin D deficiency was associated with lipid pathway differences, most notably in sphingolipid metabolism. Longitudinal and mechanistic studies are warranted to clarify the temporal dynamics and biological significance of these lipid-metabolic signatures.
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