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Objective: The effects of Helicobacter pylori infection and its associated gastric histology on [alpha]-tocopherol and [beta]-carotene concentrations in serum, gastric juice and antral mucosa were investigated in patients undergoing routine gastroscopy for investigation of dyspepsia.

Method: Eighty-six patients were studied. Highperformance liquid chromatography was used to measure [alpha]-tocopherol and [beta]-carotene concentrations. H. pylori infection was assessed by histology, bacterial culture, rapid urease test and serology.

Results: No obvious association was found between age, sex, smoking or endoscopic diagnosis and [alpha]-tocopherol or [beta]-carotene concentrations in serum, gastric juice and antral mucosa. However, alcohol drinkers had significantly lower antral mucosal and gastric juice [beta]-carotene concentrations compared to non-drinkers. Gastric juice [beta]-carotene concentration was markedly lower in patients infected with H. pylori than uninfected controls (2.9 nmol/l (interquartile range 0.3-4.3) versus 4.6 nmol/l (interquartile range 3.5-7.6), P = 0.01), but there was no significant difference in serum or gastric mucosal [beta]-carotene concentrations between the two patient groups. The presence of gastric atrophy and intestinal metaplasia was significantly associated with reduced mucosal [alpha]-tocopherol and [beta]-carotene concentrations. Furthermore, antral mucosal [alpha]-tocopherol concentrations decreased progressively as antral mucosal histology changed from normal to chronic gastritis alone and finally to atrophy and intestinal metaplasia.

Conclusion: Gastric [alpha]-tocopherol and [beta]-carotene concentrations are affected by H. pylori-associated gastric histological changes, and these findings suggest that H. pylori infection may not only impair the protective role of vitamin C, but also of [alpha]-tocopherol and [beta]-carotene in the stomach. Eur J Gastroenterol Hepatol 12:497-503

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