Influence of serum vitamin D level on Helicobacter pylori eradication: A multi-center, observational, prospective and cohort study

Abstract

Objectives: This study was designed to test whether serum vitamin D levels affected Helicobacter pylori (H. pylori) infection and eradication rates.

Methods: A multicenter observational prospective cohort study was conducted. A total of 496 H. pylori^- positive (H. pylori⁺ ) and 257 H. pylori-negative (H. pylori^- ) patients were enrolled from four hospitals in China. Baseline serum vitamin D levels were measured and a ¹³ C-urea breath test (UBT) was performed for all the participants. The H. pylori⁺ patients were divided into two subgroups based on their serum vitamin D levels (<10 or ≥10 ng/mL). A second ¹³ C-UBT was performed between 4 and 8 weeks after 14-day bismuth-containing quadruple eradication therapies. Factors potentially affecting H. pylori eradication were determined using a questionnaire survey.

Results: Serum vitamin D levels were significantly lower in the H. pylori⁺ group than in the H. pylori^- group ([17.0 ± 6.9] ng/mL vs [19.2 ± 8.0] ng/mL, P = 0.000). H. pylori eradication rate significantly differed between patients with serum vitamin D levels of <10 ng/mL and ≥10 ng/mL (71.7% vs 87.3%, P = 0.005). A multivariate analysis showed that having serum vitamin D level ≥10 ng/mL was an independent risk factor for a successful H. pylori eradication (odds ratio 0.381, 95% confidence interval 0.183-0.791, P = 0.010).

Conclusions: Serum vitamin D level may affect H. pylori infection and its eradication. Randomized controlled trials are needed to find out whether vitamin D supplements may increase the H. pylori eradication rate.

Keywords: Helicobacter pylori; eradication; infection; vitamin D.