Frequency of dyspeptic symptoms, anxiety, depression and health-related quality of life among patients with chronic gastritis according to Helicobacter pylori CagA and VacA status: a cross-sectional study

Abstract

Objective — to determine the frequency of dyspeptic symptoms, anxiety and depression and to describe health‑related quality of life in patients with chronic gastritis according to Helicobacter pylori cytotoxin‑associated gene A and vacuolating cytotoxin A status. Materials and methods. This cross‑sectional study included a total of 84 patients with H. pylori‑associated chronic gastritis (CG). Based on H. pylori virulence factors status patients were categorized into 2 groups: 50 patients with the cytotoxin‑associated gene A (CagA) and vacuolating cytotoxin A (VacA)‑positive H. pylori strains (Group 1) and 34 patients with CagA‑ and VacA‑negative H. pylori strains (Group 2). The H. pylori virulence factors were determined by the polymerase chain reaction using paraffin stomach biopsies. Serum IgA and IgG antibodies to CagA and VacA were evaluated by solid‑phase enzyme‑linked immunoabsorbent assay. The Hospital Anxiety and Depression Scale (HADS) was used to identify anxiety disorders and depression. The MOS 36‑Item Short Form Health Survey (SF‑36) questionnaire was used to assess the health‑related quality of life (HRQoL). Statistical analysis was performed using Stata 11 and Statistica 6 software packages. Results. Patients with CagA‑ and VacA‑positive H. pylori strains were more likely to have epigastric pain than patients with CagA‑ and VacA‑negative H. pylori strains (60% vs. 35.3%, p=0.026). No statistical difference was observed between the frequency of epigastric burning, early satiety, and postprandial fullness in both groups (р >0.05). Anxiety and depression were significantly more prevalent in patients with CagA‑ and VacA‑positive H. pylori strains (p=0.041; р=0.032, respectively). Patients of Group 1 had significantly lower HRQoL in the domains of Role‑Physical (50 vs. 75; p=0.0001), Bodily Pain (57.5 vs. 77.5; p=0.0001), General Health (45 vs. 75; p=0.0001), Vitality (55 vs. 80; p=0.0011) and Mental Health (56 vs. 84; p=0.0001). Conclusions. H. pylori CagA and VacA‑positive status is an important factor that may have an impact on the clinical course of H. pylori‑associated gastritis. Higher frequency of epigastric pain, anxiety, and depression, as well as lower health‑related quality of life were observed in patients with CagA‑ and VacA‑positive H. pylori strains.