Vascular endothelial function in pediatric patients with Helicobacter pylori infection and its response to Helicobacter pylori eradication.

OBJECTIVES

This study evaluated enothelial function in children with Helicobacter pylori (H. pylori) using flow-mediated dilatation (FMD) and assessed the effect of eradication therapy.

METHODS

Sixty symptomatic children were enrolled consecutively and divided into two groups after endoscopy: 30 children with confirmed H. pylori infection, and 30 children with negative H. pylori. Thirty age- and sex-matched healthy children served as controls. Complete blood count, high-sensitivity C-reactive protein (hs-CRP), and complete lipid profiles were obtained. Endothelial function was assessed by brachial artery FMD. H. pylori positive patients received triple therapy for 2 weeks and were reassessed after 3 months.

RESULTS

H. pylori-positive children had significantly higher hs-CRP (6.7 ± 2.3), cholesterol (190.2 ± 31.2), triglycerides (133.2 ± 60.5), and low-density lipoprotein (129.6 ± 24.7) than H. pylori-negative (2.9 ± 1.6, 167.6 ± 41.0, 86.3 ± 23.6, and 95.5 ± 28.8) and controls (0.7 ± 0.2, 151.8 ± 31.3, 90.5 ± 32.5, and 84.5 ± 23.3) (p < 0.001). Conversely, hemoglobin (9.7 ± 1.2), high-density lipoprotein (HDL) (35.9 ± 9.1), and FMD (6.07 ± 1.60) were significantly lower compared to the H. pylori-negative (11.5 ± 0.8, 45.4 ± 13.3, and 9.500 ± 1.20) and controls (11.7 ± 0.9, 55.0 ± 10.1, and 9.80 ± 1.20) (p < 0.001). After eradication, responders showed significant increases in hemoglobin, HDL, and FMD with significant decreases in hs-CRP and other lipid profiles (p < 0.001). FMD correlated negatively with symptoms' duration, hs-CRP, cholesterol, and Sydney score, but positively with HDL.

CONCLUSION

Children with H. pylori infection exhibited endothelial dysfunction and dyslipidemia, both of which improved significantly after successful eradication.