Helicobacter pylori May Hinder Efficacy of Sleeve Gastrectomy in Patients With Diabetes

Helicobacter pylori infection may curb the benefit of sleeve gastrectomy in patients with obesity and diabetes, according to study findings published online in the International Journal of Obesity.

The study reported the effects of sleeve gastrectomy in 40 patients with obesity, diabetes mellitus (DM), and H pylori infection. Researchers separated patients with obesity into four groups: non-DM without H pylori infection (ND), non-DM with H pylori infection (ND-HP), DM, and DM with H pylori infection (DM-HP).

At 12 months after sleeve gastrectomy, overall weight loss was similar among the four groups, according to the study. Indicators of blood glucose, lipids, and hepatic steatosis improved in each. However, decreases in fasting glucose, HbA1c, ALT, and hepatic steatosis, as well as an increase in high-density lipoprotein, were significant in the DM group only. In contrast, the DM-HP group showed no significant differences in the indicators after surgery.

“Clinical parameters improved in all groups following sleeve gastrectomy. However, individuals harboring H pylori did not show significant differences in clinical improvement,” wrote the researchers. “This suggests that the efficacy of surgery may be hindered depending on the presence of H pylori infection in patients with diabetes and obesity.”

The study found that before sleeve gastrectomy, the ND group had the greatest diversity of gastric microbiota, followed by the DM group, the ND-HP group, and finally the DM-HP group.

A correlation analysis between the preoperative gastric microbiome and clinical data found that most of the top 20 gastric microbiota were negatively associated with glucose metabolism in the ND-HP group. H pylori infection, meanwhile, was positively associated with pre-insulin levels, researchers reported.

Reference

Park YS, Ahn K, Yun K, et al. Effect of Helicobacter pylori on sleeve gastrectomy and gastric microbiome differences in patients with obesity and diabetes. Int J Obes. Published online August 24, 2024. doi:10.1038/s41366-024-01611-6