# Evaluating Helicobacter pylori Infection as a Risk Factor for Iron Deficiency Anemia: A Case-Control Approach

**Authors:** Dipendra Singh, Varun Upadhyay, Sunny Bhushan Singh, David Rimal, Objan K Rawal, Roshani Lamichhane

PMC · DOI: 10.7759/cureus.84340 · 2025-05-18

## TL;DR

This study found that Helicobacter pylori infection is strongly linked to iron deficiency anemia, with infected individuals showing much higher rates of anemia and lower iron levels.

## Contribution

The study provides empirical evidence of a direct association between H. pylori infection and iron deficiency anemia using a case-control design.

## Key findings

- IDA patients had significantly higher H. pylori positivity (87.5%) compared to controls (29.2%).
- H. pylori-positive individuals showed lower hemoglobin, ferritin, and serum iron levels.
- Poor nutrition and NSAID use were more common in H. pylori-positive participants.

## Abstract

Background

The medical community identifies Helicobacter pylori (H. pylori) infection as a growing cause of extra-gastrointestinal manifestations, which primarily affect iron deficiency anemia (IDA). The purpose of this research was to analyze how H. pylori infection relates to IDA through the case-control method.

Method

This study enrolled 48 individuals, divided into 24 (50%) cases of diagnosed IDA patients and 24 (50%) healthy controls who were matched by age and sex at Soo-Jung Hospital Doti, Rajpur Doti, Nepal. The study enrolled all subjects for laboratory examinations of blood tests, along with H. pylori infection assessments via stool antigen testing or urea breath tests. The researchers documented dietary patterns, non-steroidal anti-inflammatory drug (NSAID) use, gastrointestinal symptoms, and bleeding history. The investigators analyzed the data through SPSS Version 22 (IBM Corp., Armonk, NY) and conducted independent t-tests and chi-square tests to compare groups, with statistical significance set at p < 0.05.

Results

Research findings indicated that subjects with IDA presented a higher rate of H. pylori positivity, 21 (87.5%), compared to the control group, 7 (29.2%) (p < 0.001). The mean levels of hemoglobin, ferritin, and serum iron were significantly reduced in cases (9.7 g/dL versus 13.0 g/dL) (17.2 ng/mL versus 58.1 ng/mL), while they showed elevated total iron-binding capacity and decreased mean cellular volume levels. The proportion of patients with poor nutritional status and NSAID use was higher among participants who tested positive for H. pylori.

Conclusion

The evidence indicated that H. pylori infection establishes a direct link to the development of IDA. The combined assessment and therapy of H. pylori infection in anemic patients demonstrated promise for proper management and anemia resolution, particularly when patients have an inadequate diet or use NSAIDs.

## Linked entities

- **Diseases:** iron deficiency anemia (MONDO:0001356)
- **Species:** Helicobacter pylori (taxon 210)

## Full-text entities

- **Diseases:** infection (MESH:D007239), IDA (MESH:D018798), anemia (MESH:D000740), Helicobacter pylori Infection (MESH:D016481), gastrointestinal symptoms (MESH:D012817), bleeding (MESH:D006470)
- **Chemicals:** urea (MESH:D014508), iron (MESH:D007501)
- **Species:** Helicobacter pylori (species) [taxon 210], Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12173209