Helicobacter pylori and corpus gastric pathology are associated with lower serum ghrelin

AIM To evaluate the association of Helicobacter pylori(H. pylori), cag A genotype, and type of gastric pathology with ghrelin, leptin and nutritional status.METHODS Fasted dyspeptic adults(18-70 years) referred for an upper digestive endoscopy were enrolled in this crosssectional study. Height and weight were assessed for body mass index(BMI) calculation. A sociodemographic survey was administered and nutrient intake was evaluated with 24 h dietary recalls. Serum total ghrelin and leptin levels were analyzed by enzymelinked immunosorbent assay. 13 C-Urea Breath Test was performed and four gastric biopsies were obtained during endoscopy for histopathology and H. pylori DNA amplification and genotyping. Data analysis was performed using χ2, Mann-Whitney U, Kruskal-Wallis tests, Spearman's correlation and linear regression.RESULTS One hundred and sixty-three patients(40.8 ± 14.0 years), 98/65 females/males, were included. Overall, persistent H. pylori prevalence was 53.4%(95%CI: 45.7%-65.8%). Neither nutrient intake nor BMI differed significantly between H. pylori positive and negative groups. Serum ghrelin was significantly lower in infected patients [median 311.0 pg/m L(IQR 230.0-385.5)] than in uninfected ones [median 355.0 pg/m L(IQR 253.8-547.8)](P = 0.025), even after adjusting for BMI and gender(P = 0.03). Ghrelin levels tended to be lower in patients carrying cag A positive strains both in the antrum and the corpus; however, differences with those carrying cag A negative strains did not reach statistical significance(P = 0.50 and P = 0.49, respectively). In addition, the type and severity of gastric pathology in the corpus was associated with lower serum ghrelin(P = 0.04), independently of H.pylori status. Conversely, leptin levels did not differ significantly between infected and uninfected patients [median 1.84 ng/m L(0.80-4.85) vs 1.84 ng/m L(0.50-5.09),(P = 0.51)]. CONCLUSION H. pylori infection and severity of gastric corpus pathology are associated with lower serum ghrelin. Further studies could confirm a lower ghrelin prevalence in cag A-positive patients.

Detection of Gluten in Dishes Offered as Gluten-Free in a Gastronomic Area Located in San José, Costa Rica

Celiac disease, gluten sensitivity and gluten intolerance are health conditions that require consumers to avoid their gluten intake. In Costa Rica, Law 8975 regulates the amount of gluten permitted in prepackaged products labeled as “gluten-free”, but the parameters to be followed are not mandated for food service operations. This study investigated whether restaurants with gluten-free (GF) options in a gastronomic area of the city of San José, Costa Rica, achieved the requirements of the legislation that the dishes offered should contain less than 20 ppm gluten. Using data collected from five restaurants offering GF dishes, two provided dishes with quantities of gluten greater than 20 ppm (restaurant A, four samples and restaurant B, three samples);particularly dishes from the category “meat with sauce”. Although those dishes are naturally gluten-free, when they are handled in areas of shared production, they are exposed to the risk of cross contact, furthermore the adding of misscellaneous such as: marinades, sauces and condiments, which could contain traces of gluten or hidden gluten, a risk associated with the use of ingredients without certification GF (supplier’s practices and label declaration). Therefore improvements in food service procedures should be enforced. The findings of the present study emphasize the need to include restaurant foods in the relevant legislation to ensure that the gluten-intolerant sector of the population remains safe when eating out.