No Significant Effect of Helicobacter Pylori Eradication on Serum Lipoproteins: CagA Negative Patients May Be an Exception

ABSTRACT Objective: Heli c oba c te r pylori infection is associated with a modified lipid profile, especially lower HDL cholesterol levels. Cytotoxin Associated Gene A (CagA) positive strains with increased inflammation may further deteriorate lipids levels. Therefore, we investigated the effect of Heli c oba c te r pylori eradication on serum lipid levels, apolipo- proteins, and high sensitive C reactive protein (hsCRP) and its relation with CagA status. Methods: Fifty-one patients with positive rapid urease test (33 female, 18 male) were enrolled in the study. Seven- teen (33%) patients were CagA positive. Serum lipids, apolipoproteins, and hsCRP levels were measured at baseline and 3 months after eradication therapy. According to the urea breath test, patients with successful eradication formed Group 1, and those in whom eradication treatment failed constituted Group 2. Results: Lipid, apolipoprotein, and hsCRP levels did not change after treatment in Group 2. Serum lipids, Apo-B, and Lp(a), and hsCRP levels were also similar in Group 1 after eradication, whereas Apo-AI levels increased signifi- cantly in this group (p=0.002). In subgroup analysis, CagA negative, but not CagA positive, patients in Group 1 had increased Apo-AI levels after successful eradication. C onclusion: With the exception of an isolated increase in Apo-AI levels in CagA negative subjects, eradication of  Heli c oba c te r pylori does not seem to have a significant effect on the lipid profile. (Gazi Med J 2012; 23: 122-5) K e y Words: H. pylori , eradication, CagA, serum lipids, hsCRP OZET A mac: Helicobacter pylori enfeksiyonu ozellikle HDL’de dusme olmak uzere lipid profil degisikleri yapabilmektedir. Sitotoksin aracili gen A (CagA) pozitif suslarda, inflamasyon artacagindan lipid duzeyi uzerine etki daha belirgin olabilir. Bu nedenle, Helicobacter pylori eradikasyonun serum lipid, apolipoprotein ve yuksek duyarli CRP (ydCRP) uzerine etkisini ve bu durumun CagA ile iliskisini arastirmayi planladik. Y ontemler: Hizli ureaz testi pozitif olan 51 hasta (33 kadin, 18 erkek) calismaya alindi. Hastalarin 17’sinde (%33) CagA pozitifti. Serum lipid, apolipoprotein ve ydCRP duzeyleri baslangicta ve eradikasyon sonrasi 3. ayda olculdu. Ure nefes testi sonuclarina gore eradikasyonu basarili olanlar Grup 1, olmayanlar ise Grup 2 olarak siniflandirildi. Bulgular : Grup 2’de tedavi sonrasinda lipid, apoliprotein ve ydCRP konsantrasyonlarinda degisiklik izlenmedi. Grup 1’de lipid, Apo-B, Lp(a) ve ydCRP duzeyleri farklilik gostermezken, Apo-AI seviyesi tedavi sonrasinda onceye gore anlamli olarak yuksek bulundu (p=0.002). Alt grup analizlerinde eradikasyon sonrasi Apo-AI yukselmesinin CagA pozitif degil, negatif hastalarda izlendigi saptandi. S onuc: Sadece CagA negatif hastalarda izlenen izole Apo-AI artisi haricinde, Helicobacter pylori eradikasyonun lipid duzeyi uzerine etkisi yok gibi gorunmektedir. ( G azi Med J 2012; 23: 122-5) A na h ta r Sozcukler: H. pylori, eradikasyon, CagA, serum lipidleri, yuksek duyarli CRP