| Summary: | <p>Abstract</p> <p>Background</p> <p>Appetite and energy expenditure are regulated in part by ghrelin and leptin produced in the gastric mucosa, which may be modified by <it>H. pylori </it>colonization. We prospectively evaluated the effect of <it>H. pylori </it>eradication on meal-associated changes in serum ghrelin and leptin levels, and body weight.</p> <p>Methods</p> <p>Veterans referred for upper GI endoscopy were evaluated at baseline and ≥8 weeks after endoscopy, and <it>H. pylori </it>status and body weight were ascertained. During the first visit in all subjects, and during subsequent visits in the initially <it>H. pylori</it>-positive subjects and controls, blood was collected after an overnight fast and 1 h after a standard high protein meal, and levels of eight hormones determined.</p> <p>Results</p> <p>Of 92 enrolled subjects, 38 were <it>H. pylori</it>-negative, 44 <it>H. pylori</it>-positive, and 10 were indeterminate. Among 23 <it>H. pylori</it>-positive subjects who completed evaluation after treatment, 21 were eradicated, and 2 failed eradication. After a median of seven months following eradication, six hormones related to energy homeostasis showed no significant differences, but post-prandial acylated ghrelin levels were nearly six-fold higher than pre-eradication (p = 0.005), and median integrated leptin levels also increased (20%) significantly (p < 0.001). BMI significantly increased (5 ± 2%; p = 0.008) over 18 months in the initially <it>H. pylori</it>-positive individuals, but was not significantly changed in those who were <it>H. pylori</it>-negative or indeterminant at baseline.</p> <p>Conclusions</p> <p>Circulating meal-associated leptin and ghrelin levels and BMI changed significantly after <it>H. pylori </it>eradication, providing direct evidence that <it>H. pylori </it>colonization is involved in ghrelin and leptin regulation, with consequent effects on body morphometry.</p>
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