Obesity Surgery

, Volume 28, Issue 12, pp 3958–3964 | Cite as

Prevalence and Factors Associated with Helicobacter Pylori in Patients Undergoing Bariatric Surgery: the SOON Cohort

  • Sandrine CoumesEmail author
  • Bruno Froissart
  • Nelly Wion
  • Fabian Reche
  • Catherine Arvieux
  • Anne-Laure Borel
Original Contributions



Helicobacter Pylori (HP) infection is systematically screened for before carrying out bariatric surgery. Criteria to determine “at risk” patients and avoid systematic screening are lacking. We evaluated the prevalence of HP infection and associated predictive factors in a population of patients with class II and III obesity volunteering for bariatric surgery.

Materials and Methods

Observational, cross-sectional study of patients included in the severe obesity outcome network (SOON) cohort. All patients underwent HP screening. The relationship between plasma metabolic parameters and vitamin levels, medical history and socio-economic parameters, and HP infection was analyzed.


Data from 201 patients, median age 43 years [IQR 35; 52] (81% female) were analyzed. Forty-four patients (22%) were infected with HP and successfully treated, most with a single course of treatment, either combined antibiotics or Pylera®. HP infection was associated with social precariousness as defined by the French “Evaluation de la Précarité et des Inégalités de santé dans les Centres d’Examens de Santé” (EPICES) score (Evaluation of Poverty and Health Inequalities in Health-Assessment Centers) (OR, 1.027; 95% CI, 1.008–1.046; p < 0.004) and with higher levels of vitamin B12 (OR, 1.004; 95% CI, 1.001–1.007; p < 0.007).


The prevalence of HP infection was 22% and was associated with social precariousness. Plasma glucose/insulin and lipid/lipoprotein profiles, liver enzymes or vitamin deficiencies were not associated with HP infection. The number of characteristics associated with HP infection was insufficient to define patients who do not require HP screening before bariatric surgery.


Helicobacter pylori Bariatric surgery Prevalence 



The authors thank Matthieu Lesgoirres, clinical research assistant, for his help with the clinical research in the SOON cohort. We thank Johanna Robertson, native English speaker, for English language editing.


“Fond Agir pour les maladies chroniques” and “Agence Régionale de la Santé Auvergne Rhône-Alpes ».

Compliance with Ethical Standards

Human and Animal Rights

All patients signed informed consent for their inclusion in the SOON cohort and the study was approved by our local ethics committee. The SOON cohort is registered on (NCT02264431).

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Debs T, Petrucciani N, Kassir R, et al. Trends of bariatric surgery in France during the last 10 years: analysis of 267,466 procedures from 2005-2014. Surg Obes Relat Dis. 2016;12:1602–9.CrossRefGoogle Scholar
  2. 2.
    Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence consensus report. Gut. 2012;61:646–64.CrossRefGoogle Scholar
  3. 3.
    Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence consensus report. Gut. 2017;66:6–30.CrossRefGoogle Scholar
  4. 4.
    Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRefGoogle Scholar
  5. 5.
    Labbe E, Blanquet M, Gerbaud L, et al. A new reliable index to measure individual deprivation: the EPICES score. Eur J Pub Health. 2015;25:604–9.CrossRefGoogle Scholar
  6. 6.
    Papasavas PK, Gagne DJ, Donnelly PE, et al. Prevalence of Helicobacter pylori infection and value of preoperative testing and treatment in patients undergoing laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4:383–8.CrossRefGoogle Scholar
  7. 7.
    Bennett S, Gostimir M, Shorr R, et al. The role of routine preoperative upper endoscopy in bariatric surgery: a systematic review and meta-analysis. Surg Obes Relat Dis. 2016;12:1116–25.CrossRefGoogle Scholar
  8. 8.
    Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter. 2014;19(Suppl 1):1–5.CrossRefGoogle Scholar
  9. 9.
    Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153:420–9.CrossRefGoogle Scholar
  10. 10.
    Ibrahim A, Morais S, Ferro A, et al. Sex-differences in the prevalence of Helicobacter pylori infection in pediatric and adult populations: systematic review and meta-analysis of 244 studies. Dig Liver Dis. 2017;49:742–9.CrossRefGoogle Scholar
  11. 11.
    Erim T, Cruz-Correa MR, Szomstein S, et al. Prevalence of Helicobacter pylori seropositivity among patients undergoing bariatric surgery: a preliminary study. World J Surg. 2008;32:2021–5.CrossRefGoogle Scholar
  12. 12.
    Cerqueira RM, Correia MR, Fernandes CD, et al. Cumulative Helicobacter pylori eradication therapy in obese patients undergoing gastric bypass surgery. Obes Surg. 2013;23:145–9.CrossRefGoogle Scholar
  13. 13.
    Meier HCS, Haan MN, Mendes de Leon CF, et al. Early life socioeconomic position and immune response to persistent infections among elderly Latinos. Soc Sci Med. 2016;166:77–85.CrossRefGoogle Scholar
  14. 14.
    Laszewicz W, Iwanczak F, Iwanczak B, et al. Seroprevalence of Helicobacter pylori infection in Polish children and adults depending on socioeconomic status and living conditions. Adv Med Sci. 2014;59:147–50.CrossRefGoogle Scholar
  15. 15.
    Pere-Vedrenne C, Flahou B, Loke MF, Menard A, Vadivelu J. Other Helicobacters, gastric and gut microbiota. Helicobacter. 2017; 22 Suppl 1. Scholar
  16. 16.
    Dong Q, Xin Y, Wang L, et al. Characterization of gastric microbiota in twins. Curr Microbiol. 2017;74:224–9.CrossRefGoogle Scholar
  17. 17.
    Klymiuk I, Bilgilier C, Stadlmann A, et al. The human gastric microbiome is predicated upon infection with Helicobacter pylori. Front Microbiol. 2017;8:2508.CrossRefGoogle Scholar
  18. 18.
    Chen CY, Asakawa A, Fujimiya M, et al. Ghrelin gene products and the regulation of food intake and gut motility. Pharmacol Rev. 2009;61:430–81.CrossRefGoogle Scholar
  19. 19.
    Ando T, Mizuno S, Ishida T, et al. Plasma ghrelin isoforms and gastric ghrelin O-acyltransferase expression are influenced by Helicobacter pylori status. Nutrition. 2012;28:967–72.CrossRefGoogle Scholar
  20. 20.
    Nwokolo CU, Freshwater DA, O'Hare P, et al. Plasma ghrelin following cure of Helicobacter pylori. Gut. 2003;52:637–40.CrossRefGoogle Scholar
  21. 21.
    So WY, Tong PC, Ko GT, et al. Low plasma adiponectin level, white blood cell count and Helicobacter pylori titre independently predict abnormal pancreatic beta-cell function. Diabetes Res Clin Pract. 2009;86:89–95.CrossRefGoogle Scholar
  22. 22.
    Gowdappa HB, Mahesh M, Murthy KV, et al. Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord. BMJ Case Rep. 2013;2013Google Scholar
  23. 23.
    Shuval-Sudai O, Granot E. An association between Helicobacter pylori infection and serum vitamin B12 levels in healthy adults. J Clin Gastroenterol. 2003;36:130–3.CrossRefGoogle Scholar
  24. 24.
    Akcam M. Helicobacter pylori and micronutrients. Indian Pediatr. 2010;47:119–26.CrossRefGoogle Scholar
  25. 25.
    Khan A, Shafiq I, Hassan SM. Prevalence of vitamin B12 deficiency in patients with type II diabetes mellitus on metformin: a study from Khyber Pakhtunkhwa. Cureus. 2017;9:e1577.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Nutrition DepartmentGrenoble Alpes University HospitalGrenobleFrance
  2. 2.Hepato-Gastro-Enterology Outpatient Private Clinic “Les Cèdres”GrenobleFrance
  3. 3.Digestive Surgery DepartmentGrenoble Alpes University HospitalGrenobleFrance
  4. 4.Hypoxia-Pathophysiology (HP2) Laboratory, INSERM U1042Grenoble-Alpes UniversityGrenobleFrance

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