Vascular endothelial function in pediatric patients with Helicobacter pylori infection and its response to Helicobacter pylori eradication

OBJECTIVES: This study evaluated enothelial function in children with Helicobacter pylori (H. pylori) using flow-mediated dilatation (FMD) and assessed the effect of eradication therapy. METHODS: Sixty symptomatic children were enrolled consecutively and divided into two groups after endoscopy: 30 children with confirmed H. pylori infection, and 30 children with negative H. pylori. Thirty age- and sex-matched healthy children served as controls. Complete blood count, high-sensitivity C-reactive protein (hs-CRP), and complete lipid profiles were obtained. Endothelial function was assessed by brachial artery FMD. H. pylori positive patients received triple therapy for 2 weeks and were reassessed after 3 months. RESULTS: H. pylori-positive children had significantly higher hs-CRP (6.7 ± 2.3), cholesterol (190.2 ± 31.2), triglycerides (133.2 ± 60.5), and low-density lipoprotein (129.6 ± 24.7) than H. pylori-negative (2.9 ± 1.6, 167.6 ± 41.0, 86.3 ± 23.6, and 95.5 ± 28.8) and controls (0.7 ± 0.2, 151.8 ± 31.3, 90.5 ± 32.5, and 84.5 ± 23.3) (p < 0.001). Conversely, hemoglobin (9.7 ± 1.2), high-density lipoprotein (HDL) (35.9 ± 9.1), and FMD (6.07 ± 1.60) were significantly lower compared to the H. pylori-negative (11.5 ± 0.8, 45.4 ± 13.3, and 9.500 ± 1.20) and controls (11.7 ± 0.9, 55.0 ± 10.1, and 9.80 ± 1.20) (p < 0.001). After eradication, responders showed significant increases in hemoglobin, HDL, and FMD with significant decreases in hs-CRP and other lipid profiles (p < 0.001). FMD correlated negatively with symptoms' duration, hs-CRP, cholesterol, and Sydney score, but positively with HDL. CONCLUSION: Children with H. pylori infection exhibited endothelial dysfunction and dyslipidemia, both of which improved significantly after successful eradication.