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Leptin and Ghrelin in Relation to Helicobacter pylori Status in Adult Males

New York University School of Medicine and New York Harbor Healthcare System (J.R., F.F., P.L.S., Z.P., A.Z.O., G.I.P.-P., C.-H.T., M.J.B.), New York, New York 10010; and University of California San Francisco School of Medicine (M.S.M.), San Francisco, California 94143

Address all correspondence and reprint requests to: Martin J. Blaser, M.D., New York University School of Medicine, 550 First Avenue, OBV A-606, New York, New York 10016. E-mail: Martin.Blaser{at}med.nyu.edu.

Context: Leptin and ghrelin, hormones involved in human energy homeostasis, are both produced in the stomach.

Objective: We sought to determine whether the presence of Helicobacter pylori affects gastric and systemic levels of leptin and ghrelin.

Design, Setting, and Patients: We consecutively enrolled 256 patients referred for upper endoscopy at a Veterans Affairs outpatient endoscopy center.

Outcomes: We obtained fasting serum, fundic and antral biopsies, and gastric juice. Based on histological, biochemical, and serological assays, patients were categorized as H. pylori+ or H. pylori–. Leptin and total ghrelin levels in serum, gastric biopsies, and gastric juice were determined by specific ELISAs.

Results: Of the 256 subjects, 120 were H. pylori+ and 96 were H. pylori–; 40 patients of indeterminate status were excluded. Serum and fundic leptin levels correlated with body mass index in the H. pylori+ (r = 0.35; P < 0.0001 and r = 0.35; P < 0.0001, respectively) and H. pylori– (r = 0.65; P < 0.0001 and r = 0.41; P < 0.0001, respectively) groups, but H. pylori+ subjects had significantly lower serum leptin levels [median 2.2 ng/ml (interquartile range 0.9–4.6) vs. 4.0 ng/ml (1.7–7.2); P = 0.0003]. Serum ghrelin levels were similar in the H. pylori+ and H. pylori– groups [median 1651 pg/ml (interquartile range 845-2247) vs. 1629 pg/ml (992–2886); P = 0.23]. H. pylori status did not significantly affect gastric biopsy leptin and ghrelin levels. Ghrelin levels in gastric juice varied over 4 log₁₀ (<80–776,000 pg/ml) and correlated with gastric juice pH in the H. pylori+ group (r = 0.68; P < 0.0001).

Conclusions: These findings provide evidence that H. pylori status affects leptin and ghrelin homeostasis, presumably via intragastric interactions.