Short Communication Serum Vitamin A and Total Carotene Concentrations in Well-Nourished Children With Helicobacter pylori Infection *Yesim Ozturk, *Benal Buyukgebiz, *Nur Arslan, †Erdener Ozer, and †Banu Lebe Departments of *Pediatric Gastroenterology, Metabolism, and Nutrition and †Pathology, Dokuz Eylul University, Faculty of Medicine, Inciralti, Izmir, Turkey Helicobacter pylori infection is widely accepted as the most significant cause of gastritis and peptic ulcer dis- ease. A protective effect of antioxidant vitamins against oxidative stresses, degenerative diseases, and malig- nancy has been suggested. Furthermore, an immunoen- hancing effect of carotenes has also been suggested (1,2). The association between vitamin A, an antioxidant vita- min, and different childhood infections has been studied in many trials, and different conclusions have been made (3–6). An association between H. pylori infection and vitamin A status in children was first proposed by Khaled et al. (6). In his report, moderately malnourished children infected with H. pylori were found to have se- rum retinol concentrations indicating vitamin A defi- ciency. In the present study, serum vitamin A concen- trations and total carotene were evaluated in H. pylori- infected, but otherwise healthy children with normal nutritional status. PATIENTS AND METHODS From the patients seen at the Pediatric Gastroenterology Unit of Dokuz Eylu ¨l University Faculty of Medicine between Oc- tober 2000 and April 2001 for complaints of abdominal pain or dyspepsia, 43 patients (mean age, 14.18 ± 2.66 years; range, 8–17 years; male-to-female ratio, 17:26) who underwent en- doscopy were enrolled in this study. None of the patients were malnourished. Nutritional status of patients was evaluated by weight, height, weight-for-height, body mass index (BMI), and estimates of daily mean energy and protein intake. Of 43 pa- tients enrolled, 31 had histopathologic evaluation of antral bi- opsy specimens, and all patients had a rapid urease test. Twelve-hour fasting serum vitamin A and total carotene con- centrations were determined for all patients using the modified procedure of Neeld and Pearson (7). RESULTS Thirteen of the 19 patients whose urease test results were positive were evaluated histologically, and all 13 were found to have different densities of H. pylori. Eigh- teen of the 24 patients whose rapid urease test results were negative were evaluated histologically, and only 4 were found to have H. pylori. Patients with only a posi- tive rapid urease test (no antral biopsy specimens were available), those with a negative rapid urease test but who were positive for H. pylori on antral biopsy speci- mens, and patients with a positive rapid urease test and H. pylori in their biopsy specimens (n  23) constituted the H. pylori infection group. All other patients, i.e., with negative rapid urease test and/or negative H. pylori antral biopsy specimen (n  20) constituted the H. pylori- negative group (Table 1). Daily energy and protein in- take of all patients was adequate for their age, gender, weight, and height (8). There were no differences in age, gender, weight-for-height, and BMI between these two groups (P > 0.05; Table 1). The antral biopsy specimens, which were evaluated according to the Sydney System (9), were compared in the H. pylori-positive (n  17) and H. pylori-negative patients (n  14). Mononuclear neutrophilic infiltrates and mucosal atrophy were found to be markedly increased in the H. pylori-infected group compared with the H. pylori-negative group (Table 2). Serum vitamin A concentrations for the H. pylori- infected group ranged between 28 g/dL and 121 g/dL (mean, 50.83 ± 23.2 g/dL), whereas in the H. pylori- negative group, they ranged between 27 g/dL and 71 g/dL (mean, 50.5 ± 13.81 g/dL). The lowest value of vitamin A in the H. pylori-infected group was 28 g/dL, and two values in the H. pylori-infected group were in the mild vitamin A deficiency category (20–30 g/dL) according to World Health Organization guidelines (10). The remaining 21 patients had serum vitamin A concen- trations of more than 30 g/dL. In the H. pylori-negative group, only 1 subject had a serum vitamin A concentra- tion between 20 g/dL and 30 g/dL; the remaining 19 patients had serum vitamin A concentrations of more than 30 g/dL. There was no difference in mean serum Received November 12, 2001; accepted November 25, 2002. Address correspondence and reprint requests to Dr. Yesim Ozturk, Fellow in Pediatric Gastroenterology, Department of Pediatric Gastro- enterology, Metabolism, and Nutrition, Dokuz Eylul University, Fac- ulty of Medicine, Inciralti, Izmir 35340, Turkey (e-mail: yesimozturk@ hotmail.com). Journal of Pediatric Gastroenterology and Nutrition 36:502–504 © April 2003 Lippincott Williams & Wilkins, Inc., Philadelphia 502