In the West, the incidence of esophageal adenocarcinoma has increased over the last 30 years. This increase has coincided with a decrease in the prevalence of Helicobacter pylori.
Trends of increasing esophageal adenocarcinoma can be linked to increasing gastro-esophageal reflux disease (GERD). This in turn can be linked to an increasingly obese population.
| Plasma ghrelin increased 75%.|
However, there is no plausible biological mechanism of association between H. pylori, obesity, and GERD.
In this study, researchers from England assessed ghrelin in 10 asymptomatic H. pylori positive subjects. Ghrelin is a peptide produced in the stomach, which regulates appetite, food intake, and body composition.
The research team measured plasma ghrelin, leptin, and gastrin for 6 hours after an overnight fast, both before and after cure of H. pylori.
The team also assessed 24 hour intragastric acidity.
They found that after cure, median integrated plasma ghrelin increased from 1160.5 pg/ml.h to 1910.4 pg/ml.h. This was a 75% increase.
The team determined that this change was associated with a 14% increase in 24 hour intragastric acidity, and non-significant changes in leptin and gastrin.
There was a significant positive correlation between plasma ghrelin and intragastric acidity.
Dr Nwokolo's team concluded, "After H. pylori cure, plasma ghrelin increased profoundly in asymptomatic subjects".
"This could lead to increased appetite and weight gain, and contribute to the increasing obesity seen in Western populations where H. pylori prevalence is low".
"This plausible biological mechanism links H. pylori, through increasing obesity and GERD, to the increase in esophageal adenocarcinoma observed in the West".