Vitamin D deficiency and risk of Helicobacter pylori infection in older adults: a cross-sectional study
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Abstract
Background
Vitamin D deficiency is known to cause increased predisposition to various infectious diseases and the addition of vitamin D to antimicrobial treatment may improve treatment responses. However, the relationship between vitamin D and Helicobacter pylori (H. pylori) remains to be determined.
Aims
To assess the association between vitamin D deficiency and H. pylori infection.
Methods
This cross-sectional study included patients aged 65 and over, who underwent gastroscopy and had gastric biopsy performed between 2010 and 2017. Of the 441 patients, 254 had available 25-hydroxyvitamin D level results and were included in the analyses. Patients were categorized into H. pylori (+) and H. pylori (−) groups, according to histopathological examination results of gastric biopsies. Serum 25(OH) vitamin D levels less than 20 ng/mL were defined as vitamin D deficiency.
Results
Of all patients, 43 were H. pylori (+) and 211 were H. pylori (−). More patients had vitamin D deficiency (< 20 ng/mL) in the H. pylori (+) group than the H. pylori (−) group (86% vs 67.3%, p = 0.014). The proportion of H. pylori (+) patients decreased across increasing quartiles of 25(OH) vitamin D levels (p for trend = 0.010). In multivariable logistic regression analysis, vitamin D deficiency was associated with increased odds of H. pylori infection after adjustment for age, gender, and Charlson Comorbidity Index (OR = 3.02, 95% CI 1.19–7.69, p = 0.020).
Conclusion
Vitamin D deficiency can be associated with increased risk of H. pylori infection. The potential protective effect of vitamin D against H. pylori infection and its possible role in the treatment of H. pylori should be evaluated in prospective trials.
Keywords
Vitamin D deficiency Helicobacter pylori Aged Gastroscopy 25-Hydroxyvitamin D 2Notes
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Ethical approval
This study was approved by institutional ethical board of Ankara University and was conducted in compliance with Declaration of Helsinki.
Informed consent
For this type of study, formal consent is not required.
References
- 1.Pounder RE, Ng D (1995) The prevalence of Helicobacter pylori infection in different countries. Aliment Pharmacol Ther 9(Suppl 2):33–39PubMedGoogle Scholar
- 2.Megraud F (2003) When and how does Helicobacter pylori infection occur? Gastroenterol Clin Biol 27(Pt 2):374–379PubMedGoogle Scholar
- 3.Pilotto A, Salles N (2002) Helicobacter pylori infection in geriatrics. Helicobacter 7(Suppl 1):56–62CrossRefPubMedGoogle Scholar
- 4.Regev A, Fraser GM, Braun M et al (1999) Seroprevalence of Helicobacter pylori and length of stay in a nursing home. Helicobacter 4:89–93CrossRefPubMedGoogle Scholar
- 5.NIH Consensus Conference (1994) Helicobacter pylori in peptic ulcer disease. NIH consensus development panel on Helicobacter pylori in peptic ulcer disease. JAMA 272:65–69Google Scholar
- 6.Schistosomes, liver flukes and Helicobacter pylori. IARC Working Group on the evaluation of carcinogenic risks to humans. Lyon, 7–14 June 1994 (1994). IARC Monogr Eval Carcinog Risks Hum 61:1–241Google Scholar
- 7.Rathbone B, Martin D, Stephens J et al (1996) Helicobacter pylori seropositivity in subjects with acute myocardial infarction. Heart 76:308–311CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Haider AW, Wilson PW, Larson MG et al (2002) The association of seropositivity to Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus with risk of cardiovascular disease: a prospective study. J Am Coll Cardiol 40:1408–1413CrossRefPubMedGoogle Scholar
- 9.Kountouras J, Tsolaki M, Gavalas E et al (2006) Relationship between Helicobacter pylori infection and Alzheimer disease. Neurology 66:938–940. https://doi.org/10.1212/01.wnl.0000203644.68059.5f CrossRefPubMedGoogle Scholar
- 10.Kountouras J, Boziki M, Gavalas E et al (2009) Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease. J Neurol 256:758–767. https://doi.org/10.1007/s00415-009-5011-z CrossRefPubMedGoogle Scholar
- 11.DuBois S, Kearney DJ (2005) Iron-deficiency anemia and Helicobacter pylori infection: a review of the evidence. Am J Gastroenterol 100:453–459. https://doi.org/10.1111/j.1572-0241.2005.30252.x CrossRefPubMedGoogle Scholar
- 12.Muhsen K, Cohen D (2008) Helicobacter pylori infection and iron stores: a systematic review and meta-analysis. Helicobacter 13:323–340. https://doi.org/10.1111/j.1523-5378.2008.00617.x CrossRefPubMedGoogle Scholar
- 13.Carmel R, Aurangzeb I, Qian D (2001) Associations of food-cobalamin malabsorption with ethnic origin, age, Helicobacter pylori infection, and serum markers of gastritis. Am J Gastroenterol 96:63–70. https://doi.org/10.1111/j.1572-0241.2001.03453.x CrossRefPubMedGoogle Scholar
- 14.Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281. https://doi.org/10.1056/NEJMra070553 CrossRefPubMedGoogle Scholar
- 15.Bischoff-Ferrari HA, Giovannucci E, Willett WC et al (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28CrossRefPubMedGoogle Scholar
- 16.American Geriatrics Society Workgroup on Vitamin, D. Supplementation for Older Adults (2014) J Am Geriatr Soc 62:147–152. https://doi.org/10.1111/jgs.12631 CrossRefGoogle Scholar
- 17.Holick MF (2006) Resurrection of vitamin D deficiency and rickets. J Clin Invest 116:2062–2072. https://doi.org/10.1172/JCI29449 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Nagpal S, Na S, Rathnachalam R (2005) Noncalcemic actions of vitamin D receptor ligands. Endocr Rev 26:662–687. https://doi.org/10.1210/er.2004-0002 CrossRefPubMedGoogle Scholar
- 19.Lee DM, Tajar A, O’Neill TW et al (2011) Lower vitamin D levels are associated with depression among community-dwelling European men. J Psychopharmacol 25:1320–1328. https://doi.org/10.1177/0269881110379287 CrossRefPubMedGoogle Scholar
- 20.Bischoff-Ferrari HA, Dietrich T, Orav EJ et al (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or = 60 y. Am J Clin Nutr 80:752–758CrossRefPubMedGoogle Scholar
- 21.Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al (2009) Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339:b3692. https://doi.org/10.1136/bmj.b3692 CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Balion C, Griffith LE, Strifler L et al (2012) Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology 79:1397–1405. https://doi.org/10.1212/WNL.0b013e31826c197f CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Wang L, Song Y, Manson JE et al (2012) Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 5:819–829. https://doi.org/10.1161/CIRCOUTCOMES.112.967604 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Jenab M, Bueno-de-Mesquita HB, Ferrari P et al (2010) Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ 340:b5500. https://doi.org/10.1136/bmj.b5500 CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Basyigit S, Unsal O, Uzman M et al (2017) Relationship between Helicobacter pylori infection and celiac disease: a cross-sectional study and a brief review of the literature. Prz Gastroenterol 12:49–54. https://doi.org/10.5114/pg.2017.65681 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Nnoaham KE, Clarke A (2008) Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 37:113–119. https://doi.org/10.1093/ije/dym247 CrossRefPubMedGoogle Scholar
- 27.Laaksi I, Ruohola JP, Tuohimaa P et al (2007) An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr 86:714–717CrossRefPubMedGoogle Scholar
- 28.Shalaby SA, Handoka NM, Amin RE (2018) Vitamin D deficiency is associated with urinary tract infection in children. Arch Med Sci 14:115–121. https://doi.org/10.5114/aoms.2016.63262 CrossRefPubMedGoogle Scholar
- 29.Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Salles-Montaudon N, Dertheil S, Broutet N et al (2002) Detecting Helicobacter pylori infection in hospitalized frail older patients: the challenge. J Am Geriatr Soc 50:1674–1680CrossRefPubMedGoogle Scholar
- 31.Kawaura A, Takeda E, Tanida N et al (2006) Inhibitory effect of long term 1.ALPHA.-Hydroxyvitamin D3 administration on Helicobacter pylori infection. https://doi.org/10.3164/jcbn.38.103
- 32.Antico A, Tozzoli R, Giavarina D et al (2012) Hypovitaminosis D as predisposing factor for atrophic type A gastritis: a case–control study and review of the literature on the interaction of Vitamin D with the immune system. Clin Rev Allergy Immunol 42:355–364. https://doi.org/10.1007/s12016-011-8255-1 CrossRefPubMedGoogle Scholar
- 33.Yildirim O, Yildirim T, Seckin Y et al (2017) The influence of vitamin D deficiency on eradication rates of Helicobacter pylori. Adv Clin Exp Med 26:1377–1381. https://doi.org/10.17219/acem/65430 CrossRefPubMedGoogle Scholar
- 34.Kearns MD, Alvarez JA, Seidel N et al (2015) Impact of vitamin D on infectious disease. Am J Med Sci 349:245–262. https://doi.org/10.1097/MAJ.0000000000000360 CrossRefPubMedPubMedCentralGoogle Scholar
- 35.Wang TT, Nestel FP, Bourdeau V et al (2004) Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 173:2909–2912CrossRefPubMedGoogle Scholar
- 36.Ramanathan B, Davis EG, Ross CR et al (2002) Cathelicidins: microbicidal activity, mechanisms of action, and roles in innate immunity. Microbes Infect 4:361–372CrossRefPubMedGoogle Scholar
- 37.Guo L, Chen W, Zhu H et al (2014) Helicobacter pylori induces increased expression of the vitamin d receptor in immune responses. Helicobacter 19:37–47. https://doi.org/10.1111/hel.12102 CrossRefPubMedGoogle Scholar
- 38.Wehkamp J, Schauber J, Stange EF (2007) Defensins and cathelicidins in gastrointestinal infections. Curr Opin Gastroenterol 23:32–38. https://doi.org/10.1097/MOG.0b013e32801182c2 CrossRefPubMedGoogle Scholar
- 39.Rockett KA, Brookes R, Udalova I et al (1998) 1,25-Dihydroxyvitamin D3 induces nitric oxide synthase and suppresses growth of Mycobacterium tuberculosis in a human macrophage-like cell line. Infect Immun 66:5314–5321PubMedPubMedCentralGoogle Scholar