The influence of vitamin D deficiency on eradication rates of Helicobacter pylori

Abstract

Background. Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. Objectives. In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H. pylori. Material and methods. 220 patients diagnosed with H. pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H. pylori. Gastric biopsies obtained at endoscopy were examined for H. pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H. pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of < 10 ng/mL, while group 2 (sufficient) had a vitamin D level of >= 10 ng/mL. Results. Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 +/- 4.7 vs 19.03 +/- 8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). Conclusions. Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori, which may lead to a need for supplementation of vitamin D before eradication of H. pylori.