Folate and Homocysteine Levels and Their Association with Dietary Intakes in Iranian Patients Infected with Helicobacter Pylori: a Case-Control Study

  • Leila Javadi Department of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Bahram Pourghassem Gargari Mail Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Shabnam Salekzamani Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
  • Rana Yousefzadeh Department of Biology, Tabriz University of Medical Sciences, Tabriz, Iran.
Keywords:
Folate, Homocysteine, Helicobacter pylori, Dietary intakes

Abstract

The association between Helicobacter pylori (HP) infection and concentration of folate or homocysteine are still unclear. The aim of the present study was to assess the effect of  HP infection on folate and homocysteine concentrations in patients infected with HP and healthy participants. We also assessed dietary intakes of folate, vitamins B6 and B12 in two groups. In this case-control study, 44 participants with HP-infection and 46 healthy controls were studied. Participants were recruited from those referred to the central laboratory of Tabriz University of Medical Sciences. Blood samples were collected to determine serum folate and homocysteine levels. The presence of both IgG and IgA in serum was considered as HP positive. Dietary intakes were assessed in all participants by 24-hour dietary recalls by trained interviewers for three days. The mean concentration of serum folate was significantly lower in HP-positive patients than in controls (8.49 nmol/L vs. 10.95 nmol/L, respectively; P=0.01). Although the mean concentration of serum homocysteine differed between groups, statistical significance was missed (HP infected patients: 9.35 µmol/L; healthy participants: 8.96 µmol/L; P=0.064). Macro- and micronutrient intakes showed no significant difference between participants with and without HP infection. In logistic regression models, there was a negative correlation between folate concentration and HP infection even after controlling for confounding factors (OR=0.82; CI95%=0.79-0.97). In this study, authors showed that a negative association presents between HP infection and serum  folate concentrations, but the homocysteine status was not differed significantly between HP-positive and HP-negative participants.

References

Stettin D, Waldmann A, Strohle A, et al. Association between Helicobacter pylori infection, C-reactive protein and status of B vitamins. Adv Med Sci 2008;53(2):205-13.

Bahrami AR, Rahimi E, Ghasemian Safaei H. Detection of Helicobacter pylori in City Water, Dental Units' Water, and Bottled Mineral Water in Isfahan, Iran. Scientificm World J 2013;2013:280510.

Cave DR. Transmission and epidemiology of Helicobacter pylori. Am J Med 1996;100(5A):12S-7S.

Rautelin H, Kosunen TU. Helicobacter pylori and associated gastroduodenal diseases. APMIS 1991;99(1):677-95.

Tamura A, Fujioka T, Nasu M. Relation of Helicobacter pylori infection on plasma vitamin B, folic acid, and homocysteine levels in patients who underwent diagnostic coronary arteriography. Am J Gastroenterol 2002;97(4):861-6.

Redeen K, Stefan R, Anna P, et al. Homocysteine levels in chronic gastritis and other conditions: relations to incident cardiovascular disease and dementia. Dig Dis Sci 2010;55(2):351-8.

Kim YI. Folate and colorectal cancer. An evidencebased critical review. Mol Nutr Food Res 2007;51(3):267-92.

Zappacosta B, Mastroiacovo P, Persichilli S, et al. Homocysteine Lowering by Folate-Rich Diet or Pharmacological Supplementations in Subjects with Moderate Hyperhomocysteinemia. Nutrients 2013;5(5):1531-3.

Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: evidence on causality from a metaanalysis. Bmj 2002;325(7374):1202.

Gopinath B, Flood VM, Rochtchina E, et al. Homocysteine, folate, vitamin B-12, and 10-y incidence of age-related macular degeneration. Am J Clin Nutr 2013;98(1):129-35.

Hamatani R, Otsu M, Chikamoto H, et al. Plasma homocysteine and folate levels and dietary folate intake in adolescents and young adults who underwent kidney transplantation during childhood. Clin Eep Nephrol 2014:18(1):151-6.

Lewerin C, Jacobsson S, Lindstedt G, et al. Serum biomarkers for atrophic gastritis and antibodies against Helicobacter pylori in the elderly. Implications for vitamin B12, folic acid and iron status and response to oral vitamin therapy. Scand J Gastroenterol 2008;43(9):1050-6.

Rasool S, Abid S, Igbal MP, Mehboobali N, Haider G, Jafri W. Relationship between vitamin B12, folate and homocysteine levels and H. Pylori infection in patients with functional dyspepsia: A cross-section study. BMC Res Notes 2012;5(1):206.

Itou S, Goto Y, Kondo T, Nishio K, Kawai S, Ishida Y, Naito M, Hamajima N. No associations of Helicobacter pylori infection and gastric atrophy with plasma total homocysteine in Japanese. Int J Med Sci 2007;4(2):98-104.

Ozer B, Serin E, Gumurdulu Y, et al. Helicobacter pylori eradication lowers serum homocysteine level in patients without gastric atrophy. World J Gastroenterol 2005;11(18):2764-7.

Sarafnezad A, Hoodei E, Siavoshi F, Maserrat S, Jadali Z, Shahrestani T. Standardization and in-house ELISA setup for helicobacter pylori serologic diagnosis. Tehran Univ Med J 2001;59(4):1-10.

Redeen S, Ryberg A, Petersson F, Eriksson O, Nagge K, Borch K. Homocysteine Levels in Chronic Gastritis and Other Conditions. Relations to Incident Cardiovascular Disease and Dementia. Dig Dis Sci 2010;55(2):351-8.

Markle HV. Coronary artery disease associated with Helicobacter pylori infection is at least partially due to inadequate folate status. Med hypotheses 1997;49(4):289-92.

Triantafillidis J, Georgakopoulos D, Gikas A, et al. Relation between Helicobacter pylori infection, thyroid hormone levels and cardiovascular risk factors on blood donors. Hepato-Gastroenterology 2003;50(Suppl2):cccxviii-cccxx.

Santarelli L, Gabrielli M, Cremonini F, et al. Atrophic gastritis as a cause of hyperhomocysteinaemia. Aliment Pharmacol Ther 2004;19(1):107-11.

Trimarchi H, Forrester M, Schropp J, et al. Low initial vitamin B12 levels in Helicobacter pylori-positive patients on chronic hemodialysis. Nephron Clin Pract 2004;96(1):c28-c32.

Shuval-Sudai O, Granot E. An association between Helicobacter pylori infection and serum vitamin B12 levels in healthy adults. J clin gastroenterol 2003;36(2):130-3.

Bloemenkamp D, Mali W, Tanis B, et al. The relation between Helicobacter pylori and atherosclerosis cannot be explained by a high homocysteine concentration. Eur J Clin Invest 2002;32(8):549-55.

Saxena V, Markus H, Swaminathan S, et al. Hyperhomocysteinaemia, Helicobacter pylori, and coronary heart disease. Heart 1997;78(5):524.

Wolters M, Strohle A, Hahn A. Cobalamin: a critical vitamin in the elderly. Prev Med 2004;39(6):1256-66.

Wolters M, Strohle A, Hahn A. Age-associated changes in the metabolism of vitamin B (12) and folic acid: prevalence, aetiopathogenesis and pathophysiological consequences. Z Gerontol Geriatr 2004;37(2):109-35.

Stanger O, Herrmann W, Pietrzik K, et al. DACH-LIGA homocystein (german, austrian and swiss homocysteine society): consensus paper on the rational clinical use of homocysteine, folic acid and B-vitamins in cardiovascular and thrombotic diseases: guidelines and recommendations. Clin Chem Lab Med 2003;41(11):1392-403.

Sung JJ, Sanderson JE. Hyperhomocysteinaemia, Helicobacter pylori, and coronary heart disease. Heart 1996;76(4):305-7.

Cenerelli S, Bonazzi P, Galeazzi R, Testa I, Bonfigli A, Sirolla C, Giunta S, Galeazzi L, Fumelli D, Testa R. Helicobacter pylori masks differences in homocysteine plasma levels between controls and type 2 diabetic patients. EurJ Clin Invest 2002;32(3):158-62.

Whincup P, Danesh J, Walker M, Lennon L, Thomson A, Appleby P, Hawkey C, Atherton J. Prospective study of potentially virulent strains of Helicobacter pylori and coronary heart disease in middle-aged men. Circulation 2000;101(14):1647-52.

Quinlivan E, Partlin J, Nulty H, et al. Importance of both folic acid and vitamin B12 in reduction of risk of vascular disease. Lancet 2002;359(9302):227-8.

Yamada T, Searle JG, Ahnen D, et al. Helicobacter pylori in peptic ulcer disease. JAMA 1994;272(1):65-69.

Sipponen P, Laxen F, Huotari K, et al. Prevalence of low vitamin B12 and high homocysteine in serum in an elderly male population. Association with atrophic gastritis and Helicobacter pylori infection. Scan Gastroenterol 2003;38(12):1209-16.

How to Cite
1.
Javadi L, Pourghassem Gargari B, Salekzamani S, Yousefzadeh R. Folate and Homocysteine Levels and Their Association with Dietary Intakes in Iranian Patients Infected with Helicobacter Pylori: a Case-Control Study. Acta Med Iran. 53(3):162-167.
QRcode
Section
Articles