, Volume 39, Issue 2, pp 309-314

Helicobacter pylori infection and food-cobalamin malabsorption

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Two entities of considerable recent interest,Helicobacter pylori infection of the stomach and food-cobalamin malabsorption, are each intimately associated with gastric abnormalities. A possible connection between the two entities thus suggested itself and prompted us to study 98 subjects with low serum cobalamin levels but normal Schilling test results and 17 controls with normal cobalamin levels. Food-cobalamin absorption was measured with the egg yolk-cobalamin absorption test (EYCAT) and was abnormal in 56 of the 115 subjects. IgG antibody toH. pylori was found in 78% of the 27 patients with severe food-cobalamin malabsorption (EYCAT <1.0% excretion), compared with only 45% of 29 subjects with mild malabsorption (EYCAT 1.0–1.99%) and 42% of 59 subjects with normal absorption (EYCAT ≥2.0%) (x2=9.52,P<0.01). Antibody-positive patients had lower EYCAT excretion values than those without antibody (2.03±1.83% vs 3.11±2.13%,t=2.913,P=0.005). While Hispanic patients tended to malabsorb food cobalamin more frequently than did white or black patients, and men were more often antibody-positive than women, race, sex, or age characteristics were not responsible for the significant association between serologic evidence ofH. pylori infection and severe malabsorption of food cobalamin. The association that we describe suggests that gastritis induced byH. pylori predisposes to a more severe form of food-cobalamin malabsorption, among its other effects on gastric status.

This study was supported by grant DK-32640 from the National Institutes of Health, by the NIH National Center for Research Resources of the General Clinical Research Centers grant MO1 RR-43, by the Medical Research Service of the Department of Veterans Affairs, and by the Procter & Gamble Company.