Helicobacter pylori eradication and change in markers of iron stores among non-iron-deficient children in El Paso, Texas: an etiologic intervention study

J Pediatr Gastroenterol Nutr. 2011 Mar;52(3):326-32. doi: 10.1097/MPG.0b013e3182054123.

Abstract

Objectives: We assessed whether Helicobacter pylori eradication was followed by changes in iron stores among non-iron-deficient children.

Materials and methods: Double-blind randomized intervention trial on 110 asymptomatic 3- to 10-year-olds with H pylori infection assigned to any of the following 4 arms: both quadruple eradication and iron supplementation, either quadruple sequential eradication or iron supplementation, or placebo only. Hemoglobin, transferrin saturation, and serum ferritin were measured at baseline and 8 months later to assess changes according to study arm, H pylori infection status at ≥45 days, and cytotoxin-associated gene product A status.

Results: Intent-to-treat (n = 110) and per-protocol (n = 90) analyses revealed no differences across study arms in changes of iron stores. However, we found that those who had their infection eradicated had a 3-fold increased average change from baseline serum ferritin compared with that of children who remained infected (P < 0.05). Eradication of infection by cytotoxin-associated gene product A negative strains was associated with a larger ferritin increase.

Conclusions: In this double-blind randomized trial, the first among non-iron-deficient, asymptomatic H pylori-infected children living in the contiguous United States, we found no effect of H pylori eradication regarding changes in iron stores. However, those who had their infection eradicated at follow-up had a significantly larger increase in serum ferritin from baseline.

Trial registration: ClinicalTrials.gov NCT00364104.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / etiology
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Dietary Supplements
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Ferritins / blood*
  • Helicobacter Infections / blood
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori / classification
  • Helicobacter pylori / drug effects*
  • Humans
  • Intention to Treat Analysis
  • Iron, Dietary / pharmacology*
  • Male
  • Reference Values
  • Species Specificity
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Iron, Dietary
  • Ferritins

Associated data

  • ClinicalTrials.gov/NCT00364104