Endall, R and Thompson, M and Parameswaran, V and Burgess, J, The relationship of Gastrinoma in MEN 1 to Helicobacter pylori infection, Journal of Clinical Endocrinology and Metabolism, 105, (3) pp. e676-e682. ISSN 0021-972X (2020) [Refereed Article]
Copyright 2020 Endocrine Society
Context: Helicobacter pylori and Multiple Endocrine Neoplasia Type 1 (MEN 1) are risk factors for hypergastrinemia. Gastrin-secreting neoplasms of the foregut mucosa are both a source of, and potentially stimulated by, hypergastrinemia.
Objective: To determine the relationship between H pylori exposure and the prevalence and severity of hypergastrinemia in patients with MEN 1.
Design, setting & patients: Cross-sectional analysis of patients with a common MEN1 gene mutation managed at a tertiary referral hospital that underwent fasting serum gastrin and H pylori serum IgG measurement.
Intervention: H pylori IgG and serum gastrin concentration, determined via immunoassay.
Main outcome measures: The prevalence and severity of hypergastrinemia and its relationship to past H pylori exposure.
Results: Thirty-four of 95 (36%) patients were H pylori IgG seropositive. H pylori seropositive patients were significantly more likely to exhibit hypergastrinemia compared with seronegative patients (relative risk [RR] 1.72, P = .023). H pylori exposure also predicted severe hypergastrinemia (RR 3.52, P = .026 and RR 9.37, P = .031 for patients with gastrin ≥ ×4 and ≥ ×8 the upper limit of normal [ULN], respectively). Gastrin concentrations ≥ ×10 ULN occurred exclusively in H pylori seropositive patients (0/61 vs 6/34, P = .001). Serum gastrin and alpha subunit were positively associated in H pylori-exposed (β = 0.69, P = .001), but not in H pylori-unexposed patients.
Conclusion: Past H pylori exposure was associated with increased prevalence and severity of hypergastrinemia in MEN 1 patients. Past H pylori-related hypergastrinemia may contribute to the pathogenesis of ongoing gastrin hypersecretion by susceptible foregut neuroendocrine tissues.
|Item Type:||Refereed Article|
|Keywords:||Gastrinoma, MEN 1, Helicobacter pylori|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Thompson, M (Dr Michael Thompson)|
|UTAS Author:||Parameswaran, V (Associate Professor Venkat Parameswaran)|
|UTAS Author:||Burgess, J (Professor John Burgess)|
|Web of Science® Times Cited:||2|
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