Synergistic Impact of Helicobacter pylori Infection on Serum Trace Element Disturbances in Patients with Crohn's Disease

Yasir Saadi  Mahmood; Mohammed Yawoz  Noraldeen

doi:10.56286/kk8tkx96

Authors

Yasir Saadi Mahmood Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Northern Technical University, 36001 Kirkuk, Iraq https://orcid.org/0009-0000-0934-5281
Prof. Dr. Mohammed Yawoz Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Northern Technical University, 36001 Kirkuk, Iraq https://orcid.org/0000-0001-8718-4364

DOI:

https://doi.org/10.56286/kk8tkx96

Keywords:

Crohn’s disease, Helicobacter pylori, Zinc, Copper, Iron, Trace elements

Abstract

Background: Crohn’s disease (CD) is a chronic transmural inflammatory disorder that profoundly disrupts trace element homeostasis. Co-infection with Helicobacter pylori (H. pylori) may further compound these disturbances through gastric acid suppression, bacterium-mediated micronutrient sequestration, and amplified systemic inflammation. Objectives: To evaluate and compare serum copper, iron, and zinc in CD patients with H. pylori co-infection (H. pylori +CD), CD patients without H. pylori (CD only), and healthy controls. Methods: A cross-sectional study at Ibn Sina Teaching Hospital, Mosul, Iraq (December 2025– April 2026) enrolled 130 participants distributed as 70 H. pylori-negative CD patients, 30 H. pylori +CD patients, and 30 healthy controls. H. pylori was diagnosed by stool antigen test (SAT). Serum trace elements were measured using the Cobas Pure analyzer. One-way ANOVA was used for trace element comparisons; categorical demographic variables were analysed by Pearson’s chi-square test. Results: Three groups were demographically comparable, with no significant difference between H. pylori +CD and CD-only groups in sex (p=0.432) or age (p=0.23). One-way ANOVA revealed highly significant differences across groups for all trace elements (p<0.001). Serum copper increased stepwise from 98.40±10.30 µg/dL in controls to 131.40±13.94 µg/dL in CD-only and 139.35±15.74 µg/dL in H. pylori +CD patients. Conversely, serum iron declined progressively from 100.30±19.80 µg/dL in controls to 89.05±18.99 µg/dL in CD-only and 77.50±18.20 µg/dL in H. pylori +CD patients. Serum zinc showed the steepest decline from 90.20±13.50 µg/dL in controls to 75.86±15.29 µg/dL in CD-only and 64.00±15.40 µg/dL in H. pylori +CD patients. Conclusion: H. pylori co-infection synergistically amplifies copper elevation and compounds iron and zinc depletion in CD beyond what the disease alone causes, through distinct and additive pathophysiological mechanisms. H. pylori eradication should be an integral component of comprehensive nutritional management in CD.

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