Evaluation of Helicobacter pylori infection and endothelial dysfunction in children referred to a tertiary hospital

Background. Helicobacter pylori (H. pylori) has been associated with a range of extragastroduodenal complications other than the gastroduodenal conditions. Its potential contribution to cardiovascular pathology, particularly endothelial dysfunction, is increasingly recognized. This study aimed to evaluate the impact of H. pylori infection on endothelial function in children. Methods. This quasi-experimental research included 50 children aged 4-18 years, referred to a tertiary pediatric gastroenterology center with confirmed H. pylori infection. Diagnosis was established through endoscopic and histopathological findings. Echocardiographic assessment was performed, and carotid intima-media thickness (IMT) and flow-mediated dilation (FMD) were measured at three time points: baseline (admission), 1.5 months, and 3 months after antibiotic eradication therapy started. Data were analyzed using paired t-tests and repeated measures ANOVA, with significance set at p < 0.05. Results. Significant improvements in vascular diameter at rest, during the hyperemic state, and in FMD were observed between baseline and 1.5 months later. All four vascular parameters improved significantly after 3 months of treatment. Significant improvement in FMD was observed at both 6 and 12 weeks following H. pylori eradication (p < 0.01). No significant change was seen in IMT values. Baseline IMT and arterial diameter positively correlated with patient age. Conclusion. Eradication of H. pylori significantly improves FMD and vascular parameters, indicating a potential role in mitigating early endothelial dysfunction in children. Further studies are warranted to investigate the long-term cardiovascular benefits of H. pylori eradication in the pediatric population.