Mucus Thickness of the Gastric Mucosa and Helicobacter pylori Infection in Dyspeptic Patients with or without Diabetic Symptom

Jacobus Albertus, Abdul Aziz Rani, Marcellus Simadibrata, Murdani Abdullah, Ari Fahrial Syam, Rino Alvani Gani, Imam Subekti

Abstract


Background: Chronic Helicobacter pylori (H. pylori) infection affects the mechanisms of gastric mucosal protection. In patients with diabetes mellitus, data on the prevalence of H. pylori infection are scanty and contradictory. We have examined, using histological fixation technique, the thickness of the adherent mucus gel layer in the gastric mucosal and H. pylori infection in dyspeptic patients with or without diabetes.
Method:
A cross-sectional study was conducted in 86 dyspeptic patients consisted of 43 diabetics and 43 non-diabetics patients. In all cases, upper gastrointestinal endoscopy were performed, measurement of the gastric corpus and antral mucus thickness was carried out at the corpus and antral biopsy specimens were snap frozen and cryostat sections were stained using a hematoxyline eosin. One biopsy within 2 cm of the pylorus was examined for detection of H. pylori status by using polymerase chain reaction (PCR).
Results:
In all sections the mucus layer was continuous. At the gastric corpus and antrum, the mucus thickness of diabetic patients was thinner than non diabetic patients: 35.2 ± 2.2 µ m and 43.9 ± 3.8 µ vs 45.2 ± 2.5 µ m and 51.2 ± 2.2 µ m. The results were significantly different (p = 0.001). The difference of H. pylori prevalence between diabetics (52.5%) and nondiabetics patients (47.5%) was not significant (p = 0.67).
Conclusion:
This study shows a significant thinning of the adherent mucus gel layer both in diabetic patients and H. pylori-positive individuals. No difference has been found between patients with H. pylori infection and diabetes mellitus.  
Keywords:
mucus thickness, Helicobacter pylori infection, diabetic patient

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DOI: https://doi.org/10.24871/1132010112-120

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