Effects of Vitamin D in H.pylori Eradication Therapy

Abstract

Background: Helicobacter pylori infection induces not only chronic inflammation of the stomach but also precipitates the development of gastric ulcers, gastric atrophy, tumors, and gastric lymphoma. This pathogenic process has emerged as a prominent global health concern, and our country is not an exception to this trend. In Mongolia, a staggering 75.9% of the population is afÒicted with H. pylori, positioning it among the nations with the highest prevalence rates worldwide.In the years 2012-2016, our country conducted a national survey on micronutrients and vitamin D. The findings revealed a pronounced deficiency of vitamin D in the plasma of Mongolians, with rates reaching 99% during winter and 38% during summer. Aim: In this study, our objective was to examine the potential influence of serum levels of 25-hydroxy-vitamin D (25(OH) D) on the eradication rates of H. pylori. Materials and Methods: Eighty-five patients diagnosed with H. pylori gastritis, confirmed through endoscopic examination and urea breath test, underwent measurement of 25-OH vitamin D levels via blood assessment before initiating eradication therapy for H. pylori. Based on the 25-OH vitamin D levels, patients were categorized into two groups: group 1 (deficient), with a vitamin D level of <20 ng/mL, and group 2 (sufÏcient), with a vitamin D level of >20 ng/mL. The case group received bismuth-based quadruple therapy in addition to vitamin D, while the control group was treated with quadruple therapy alone. H. pylori eradication was assessed using the 14C-urea breath test conducted four weeks after the completion of therapy. Results: Eradication was successful in 47 patients (90.4%) in the case group and unsuccessful in 5 patients (9.6%). In the control group, 23 (69.6%) of patients achieved successful treatment, while 10 (30.3%) did not.The results, assessed through the breath urease test after H. pylori eradication treatment with vitamin D in participants with vitamin D deficiency in plasma infected with H. pylori, demonstrated a statistical significance of p<0.001. When compared to the control group (p<0.001), the difference was statistically significant. Conslusion: Among the 85 participants infected with H. pylori bacteria in the study, 61.2% exhibited vitamin D deficiency in plasma. In the case group of 52 individuals with both H. pylori infection and vitamin D deficiency, eradication treatment for H. pylori, supplemented with an additional dose of vitamin D, was administered, resulting in successful treatment for 90.4% of cases. In the control group, individuals with Helicobacter pylori (H. pylori) infection and sufÏcient vitamin D levels underwent bismuth-based quadruple therapy alone to eradicate the H. pylori infection. Among them, 23 were successfully treated, while 10 (30.3%) exhibited treatment failure.