Helicobacter pylori infection with iron deficiency anemia and subnormal growth at adolescence

ABSTRACT

It is thought that helicobacter pylori infection may influence growth rate in children. The aim of this study was to determine whether helicobacter pylori infection can contribute to growth deficit, especially in adolescent children who need large amount of iron for growth. A structured questionnaire was sent to the parents of 265 healthy children aged 10 to 15 years [mean 12.9] to obtain demographic information in the parents and the environment of the 265 questionnaires sent out, 187 [70.6%, 85 girls and 102 boys] were returned. After collecting blood samples from participants, hemoglobin, serum iron, total iron binding capacity, serum ferritin, the children were tested for H. pyloti infection by CI 3-urea breath test then,for positive one, upper gastrointestinal endoscope was done to see the antrum and biopsy specimens were obtained from the antrum from which rapid urease test was done. The effects of risk factors such as H.pylori infection, iron deficiency anemia, sex, socio economic status, type of house and crowding index on growth were analyzed during multiple regression analysis of 32 H.pylori positive children, 9 [28.1%] were below 25 centile values for height, compared with 32 of 156 [20.5] H.pylori negative children. The prevalence rate of H.plylori infection was 15.8%[27 of 171]] in children without iron deficiency anemia and 31.3% [5 of 16] in those affected. The relative risk of short stature was 2.2 [95% confidence interval [CI], 1.0 to 4.8] for iron deficiency anemia, and 1.4 [95% CI, 0.8 to 2.4] for H. pylori infection. The mean height was significantly lower in the group having both H.pylori infection and iron deficiency anemia. Therefore, H.pylori infection accompanied by iron deficiency anemia, rather than H.pylori infection per se, might delay pubertal growth