Relationship between Helicobacter pylori Infection and Serum Ferritin Level in Primary School Children in Tehran-Iran
Iron deficiency can cause cognitive and functional learning disorders in children. Some studies have reported a relationship between low serum ferritin levels in patients with anemia and Helicobacter pylori (H. pylori) infection. Therefore, we aimed to determine the relationship between these two common diseases. This descriptive analytical cross-sectional study was performed to assess serum ferritin levels and H. pylori antibody titers (IgG) among 6-12 year old healthy primary school children in Tehran during the academic year 2005-2006. Specimen collection was done by cluster and randomization methods (multistage sampling). Personal information and laboratory results were compiled in questionnaires and data were analyzed by descriptive and analytical statistics via SPSS software. 165 primary school children (43% boys, 57% girls) with mean age 9.2 ± 1.5 years were enrolled in the study. H. pylori IgG antibody titer was positive in 26% of cases with mean values of 0.79 ± 0.42 units in boys and 0.75 ± 0.39 units in girls, which showed a significant statistical difference (P=0.004). H. pylori infection was more common among children of large families or those with low economic status (P=0.002). 29% of children had low serum ferritin levels. Out of the children with low serum ferritin levels, 71% and 28% had negative and positive anti H. pylori antibody titers (IgG levels), respectively. Also, 296 children (25%) with normal ferritin levels had H. pylori infection. We did not find a significant relationship between H. pylori infection and low serum ferritin levels or iron deficiency anemia.
Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol 2006;163(2):127-34.
United Nations Administrative Committee on Coordination, Subcommittee on Nutrition (ACC/SCN). 4th Report on the Word Nutrition Situation. Geneva,mSwitzweland: ACC/SCN in Collaboration with Internationl Food Policy Research Institute; 2000.
Centers for Disease Control and Prevention (CDC). Iron deficiency: United States, 1999-2000. MMWR Morb Mortal Wkly Rep 2002;51(40):897-9.
Willows ND, Dewailly E, Gray-Donald K. Anemia and iron status in Inuit infants from northern Quebec. Can J Public Health 2000;91(6):407-10.
Samadpour K, Sheikholeslam R, Abdollahi Z, Salehi FM. The effect of weekly dose of iron supplementation for 16 and 20 weeks on the iron status ofadolescnet girls in Iran. Asia Pac J Clin Nutr2004;13(Suppl):S135.
Sungthong R, Mo-suwan L, Chongsuvivatwong V. Effects of haemoglobin and serum ferritin on cognitive function in school children. Asia Pac J Clin Nutr 2002;11(2):117-22.
Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001;107(6):1381-6.
Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Sanders; 2004. p. 1244-6.
Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics 2006;117(3):e396-404.
Süoglu OD, Gökçe S, Saglam AT, Sökücü S, Saner G. Association of Helicobacter pylori infection with gastroduodenal disease, epidemiologic factors and irondeficiency anemia in Turkish children undergoing endoscopy, and impact on growth. Pediatr Int 2007;49(6):858-63.
Zuberi BF, Afsar S, Qadeer R, Baloch I, Quraishy MS, Kumar A, Akhtar N. Hemogolbin, ferritin, vitamin B12 and halicobacter pylori infection: a study in patients who underwent upper gi endoscopy at civil hospital karachi. J Coll Physicians Surg Pak 2007;17(9):546-9.
Akcam M, Ozdem S, Yilmaz A, Gultekin M, Artan R. Serum ferritin, vitamin B(12), folate, and zinc levels in children infected with Helicobacter pylori. Dig Dis Sci 2007;52(2):405-10.
Choi JW. Does Helicobacter pylori infection relate to iron deficiency anaemia in prepubescent children under 12years of age? Acta Paediatr 2003;92(8):970-2.
Sedlácková M, Malaty H, Volf V, Frühauf P, Marx D, Soucek A, Graham DY. Helicobacter pylori infection in a group of symptomatic and asymptomatic children and adolescents in the Czech Republic. Cas Lek Cesk 2003;142(2):102-5.
Czinn SJ. Helicobacter pylori infection: detection, investigation, and management. J Pediatr 2005;146(3 Suppl):S21-6.
Mitchell HM, Li YY, Hu PJ, Liu Q, Chen M, Du GG, Wang ZJ, Lee A, Hazell SL. Epidemiology of Helicobacter pylori in southern China: identification of early childhood as the critical period for acquisition. J Infect Dis 1992;166(1):149-53.
Conrad ME, Umbreit JN. Iron absorption and transport-an update. Am J Hematol 2000;64(4):287-98.
Blecker U, Hauser B, Lanciers S, Peeters S, Suys B, Vandenplas Y. The prevalence of Helicobacter pyloripositive serology in asymptomatic children. J Pediatr Gastroenterol Nutr 1993;16(3):252-6.
Baysoy G, Ertem D, Ademoğlu E, Kotiloğlu E, Keskin S, Pehlivanoğlu E. Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 2004;38(2):146-51.