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Objective: Ghrelin is believed to influence weight evolution after bariatric surgery. Helicobacter pylori (H. pylori) infection may influence ghrelin plasma levels by affecting the ghrelin-producing cells (GPC) in the stomach. The purpose of the study was to characterize the GPC distribution in the stomach in overweight patients and the influence of H. pylori infection on them., Patients, Materials and Methods: The study group included 21 obese patients undergoing bariatric surgery with ghrelin levels and anti-H. pylori antibodies previously measured, and upper gastrointestinal endoscopy with histological evaluation of H. pylori infection performed. Immunohistochemical expression of ghrelin was quantified in gastric resection specimens., Results: The results showed a higher number of GPC in the obese women than in men (p>0.05). The highest number of GPC was detected in the gastric body, followed by the fundus and antral region (p<0.001). GPC number correlated inversely with anthropometric parameters: weight (p=0.011), body mass index (BMI) (p=0.017), waist circumference (WC) (p=0.066) was lower in patients with H. pylori infection (p>0.05) or gastritis (p>0.05), the number decreasing with the increase in depth of gastritis lesion (p>0.05)., Conclusions: The present study fulfills the characterization of GPC in obese patients, showing a higher number in women than in men, their predominant location in the gastric body, and their relationship with the anthropometric parameters (weight, BMI, WC), H. pylori infection and gastritis lesions. These results open broad perspectives for a deeper understanding of the ghrelin involvement in the obesity pathogenic mechanism, associated or not with other gastric conditions.

Helicobacter pylori (H. pylori) is the etiological factor for gastritis in more than half of the worldwide population. H. pylori infection increases the risk for gastric pathology, but could also have consequences on cardio-metabolic status. Obesity has as epidemic growth, and the only efficient long-term treatment for morbidly obese patients is currently surgery. Although of vital importance, the preoperative assessment is not standardized, including the aspects related to H. pylori infection. The aim of this prospective study was to evaluate the prevalence of H. pylori (Hp) infection in a group of patients referred to bariatric surgery and the agreement of two commonly used methods for its diagnosis. We included 70 asymptomatic obese patients consecutively for 14 months, who were evaluated by serology (anti-Hp IgG antibodies) and by histology (gastroscopy with gastric mucosa biopsy). If diagnosed, H. pylori infection was standard treated and afterwards, all patients underwent laparoscopic sleeve gastrectomy; the resected stomach was morphologically evaluated. 58.6% of patients were H. pylori positive on serology and 51.4% were H. pylori positive on histology, agreement coefficient factor kappa between the two methods being 0.686, p<0.001. The serological diagnosis had a sensibility of 90.3% and a specificity of 77.8%. The prevalence of H. pylori infection in the resected stomach was 11.4%, and was associated with more severe degrees of chronic gastritis. In conclusion, as gastroscopy should anyhow be performed in all patients referred to surgery, our data favor the histological evaluation in all patients and the eradication treatment according to its results.