The association between Helicobacter pylori infection and anthropometric, clinical, and laboratory parameters in children and adults with celiac disease: A cross-sectional study

Introduction: Both Helicobacter pylori infection and celiac disease (CD) are characterized by increased intra-epithelial cells and villi shortening, which can influence gut microbiota and immune responses. Understanding the interplay between these two conditions is essential for optimizing patient care and treatment strategies. Therefore, this study aims to investigate the prevalence of H. pylori infection and its association with various anthropometric, clinical, and laboratory factors in CD patients in Fars, Iran. Methods: In this cross-sectional study, a total of 345 adults and 649 children with CD were enrolled. Demographic data and the presence of gastrointestinal symptoms were collected through interviews. An enzyme-linked immunosorbent assay kit was used to measure serum levels of IgA anti-transglutaminase antibodies (anti-tTG). Endoscopic results were assessed to categorize CD histological damage according to the Marsh classification and differentiate people with or without H. pylori infection. Body mass index (BMI) was calculated by dividing the weight by the square of the height. Results: The prevalence of H. pylori infection was 5.1 % in children and 18.3 % in adults with CD in Fars, Iran. Significant positive relationships were identified between the occurrence of H. pylori infection and gastrointestinal symptoms (OR = 2.86, P = 0.013), BMI (β = 1.00, P = 0.049), and anti-tTG serum levels (β = 71.93, P = 0.012) in children with CD, but not in adults. Moreover, no significant association was found between H. pylori infection and histological damage in both pediatric and adult CD patients. Conclusions: The prevalence of H. pylori infection among CD patients seems to be low. Children with CD who tested positive for H. pylori infection appear to exhibit more gastrointestinal symptoms, higher BMI, and elevated anti-tTG serum levels compared to those without the infection.