Muammer BİLİCİ, İshak Özel TEKİN, Yasin ÖZTÜRK, Selim AYDEMİR, Başak DELİKANLI ÇORAKCI

FONKSİYONEL DİSPEPSİLİ HASTALARDA HELİKOBAKTER PİLORİ ERADİKASYONUNUN SERUM OKSİDE LDL DÜZEYLERİ ÜZERİNE ETKİLERİ

Amaç: Helicobacter pylori (H. pylori), ilk keşfinden itibaren sindirim sistemi ve diğer sistemlerle ilgili bir çok hastalığın patogenezinde yer almakla suçlanmıştır. İlginç olarak, sindirim sistemi dışı hastalıklarla ilgili litera- türün çoğunluğu, özellikle iskemik kalp hastalığına odaklanmıştır. Aterosklerozun ilerlemesinde oksitlenmiş düşük yoğunluklu lipoprotein (ox-LDL) önemli bir rol oynamaktadır. Bu çalışmada, H. pylori eradikasyonunun serum ox-LDL düzeyleri üzerine etkisini değerlendirmek amaçlanmıştır. Yöntem: Çalışmaya H. pylori ile ilişkili dispepsisi olan 73 hasta ve 23 sağlıklı gönüllü kontrol grubu olarak dahil edildi. Hastalara bizmut içeren dörtlü tedavi 14 gün süreyle verildi. Serum ox-LDL, LDL ve yüksek yoğunluk- lu lipoprotein (HDL) düzeyleri tedaviden önce ve 8 hafta sonra olmak üzere ölçüldü. H. pylori eradikasyonu 14C-üre nefes testi ile doğrulandı. Bulgular: Hasta ve kontrol grubu arasında yaş ve cinsiyet açısından anlamlı fark bulunmadı (sırasıyla p = 0,066 ve p = 0,475). H. pylori eradikasyonu öncesi hastalarda serum ox-LDL ve LDL düzeyleri sağlıklı kontrollere göre anlamlı olarak yüksek bulundu (sırasıyla p = 0,04 ve p = 0,046). Düzeltilebilir kardiyovasküler hastalık risk faktörü taşımayanlarda eradikasyon başarısı sonrası ox-LDL düzeylerinde anlamlı azalma saptandı (p = 0.047). Ancak, diğer hastalar arasında tedavi öncesi ve sonrası serum ox-LDL düzeylerinde istatistiksel olarak anlamlı bir fark yoktu (p> 0.05). Sonuç: H. pylori ilişkili dispepsi hastalarında eradikasyon tedavisinin ateroskleroz progresyonuna sınırlıda olsa yararlı etkisi olduğu kanaatindeyiz.

The Influence of Helicobacter Pylori Eradication on Serum Oxidized Low Density Lipoprotein in Patients With Functional Dyspepsia

Objectives: Since the discovery, Helicobacter pylori (H. pylori) it have been implicated in the pathogenesis ofseveral diseases located both in the digestive and extradigestive systems. Interestingly, the majority of theliterature on extradigestive-related disease mainly focuses on ischemic heart diseases. Oxidized low-densitylipoprotein (ox-LDL) is an important key point in the progression of atherogenesis. The aim of the presentstudy was to investigate whether the eradication of H. pylori infection affects serum ox-LDL levels.Methods: A total of 73 patients with H. Pylori–associated dyspepsia and 23 controls were included in thisstudy. Bismuth quadruple therapy was given for 14 days. Serum levels of ox-LDL, LDL and high-densitylipoprotein (HDL) were measured at baseline and 8 weeks after therapy. Successful eradication was provenwith the 14C-urea breath test.Results: There were no significant differences in terms of age and gender between the patients and controls(p=0.066 and p = 0.475, respectively). Comparing H. Pylori patients to healthy controls with respect to serumox-LDL and LDL levels were significantly higher in the patient group (p=0.04 and p=0.046 respectively). It wasnoticed that oxLDL levels were lower in eradicated patients with no correctable risk factors for cardiovasculardisease after therapy (p=0.047). However, there was no statistically significant difference in serum ox-LDLlevels between baseline and after therapy among the other patients (p>0.05).Conclusion: The findings of our study might indicate that H. pylori eradication influences the oxidation of LDL.However, the role of H. pylori infection on atherosclerosis progression is a controversial issue.

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