Can Helicobacter pylori Eradication Treatment Modify the Metabolic Response to Bariatric Surgery?

Abstract

Background: Helicobacter pylori (HP) colonization is common in severely obese patients undergoing bariatric surgery. HP eradication treatment could influence the evolution of weight loss and metabolic markers after bariatric surgery. Objective: To assess the influence of HP eradication in the clinical course of morbid obesity patients treated with bariatric surgery (gastric bypass (LRYGB) and sleeve gastrectomy (LSG)) Methods: Retrospective analysis of a prospective cohort of 229 patients that underwent bariatric surgery between 2010 and 2013 in Hospital del Mar. HP infection was tested preoperatively by gastric biopsy and, if positive, treated with omeprazole, clarithromycin, and amoxicillin for 14 days. Patients were followed at 3, 6, 12, 18, and 24 months after bariatric surgery. Short-term weight loss and metabolic outcomes were evaluated. Results: HP treated (HPt) patients had a greater reduction in BMI at 3 months after LSG (ΔBMI (kg/cm2) 8.5 ± 4.1 vs 11.3 ± 3.05 kg/m2; p = 0.004) and a reduction in the evolution of triglyceride levels from baseline to 12 months (p = 0.014) compared to HP-negative (HP−) subjects. Also, non-diabetic HPt patients had a greater reduction in glucose levels at all time points that was maintained up to 24 months after LRYGB (p = 0.003). No differences were observed in total and LDL cholesterol levels, HOMA-IR, or HbA1C. Conclusions: Preoperative HP eradication has a short-term influence on some metabolic parameters after bariatric surgery.