| The purpose of this study was to determine whether or not Helicobacter pylori (H. pylori) infection affects the hypothalamic-pituitary-adrenal (HPA) axis and to evaluate the association between vitamin D levels with H. pylori infected and eradicated patients. The glucagon stimulation test (GST) was used to assess the HPA gland axis. An H. pylor i infection was diagnosed based on the rapid urease test and histology. All infected patients received triple eradication therapy. Three months after the treatment, 14 C urea breath test was reinstituted, and GST was repeated in patients who were negative for H. pylori . Of the 43 patients, 20 (46%) were found to have a lower mean value of peak cortisol than normal responses to the GST in the H. pylori -infected subjects. In 29 subjects, H. pylori infection was successfully eradicated. Twelve (41%) out of 29 subjects were defined as having a blunted GST response and 17 (%59) subjects had normal HPA axis response to GST in the H. pylori -eradicated subjects. A significant correlation between low 25-hydroxyvitamin D 3 (25(OH)D 3 ) level and low peak cortisol response to GST was identified in the H. pylori -infected subjects. After H. pylori eradication, the positive correlation between 25(OH)D 3 level and high peak cortisol response to GST was also identified. Mean 25(OH)D 3 levels were lower in the H. pylori -infected subjects than in the H. pylori -eradicated subjects. Our results indicate an increased prevalence of blunted glucocorticoid response to GST in patients with infected H. pylori . Vitamin D deficiency is also common in the H. pylori -infected subjects and associated with blunted glucocorticoid response. These findings suggest that H. pylori eradication increases the cortisol response to GST. Vitamin D supports adrenal/cortisol production whereby a deficiency can result blunted glucocorticoid response to GST in patients with infected H. pylori . |