Helicobacter pylori seropositivity is associated with antinuclear antibodies in US adults, NHANES 1999-2000

Accelerated biological aging mediates the association between inflammatory markers with Helicobacter pylori infection and mortality

BACKGROUND

The aim of this study was to explore the systemic inflammation response in relation to mortality in Helicobacter pylori (H. pylori) infection, and whether this relationship was mediated by accelerated biological aging.

METHODS

This cross-sectional study encompassed U.S. participants from National Health and Nutrition Examination Survey (NHANES) in 1999-2000. Kaplan-Meier survival curve, Cox regression analysis, K-means clustering, mediation analysis and restricted cubic spline (RCS) were used to explore the relationships between inflammatory markers, biological aging, H. pylori infection and all-cause mortality.

RESULTS

A total of 3509 U.S. participants enrolled form NHANES 1999-2000. Compared with H. pylori seronegative participants, H. pylori seropositive participants had significantly higher all-cause mortality (P < 0.001). Among these H. pylori seropositive participants, both phenotypic age acceleration (PhenoAgeAccel) and all-cause mortality were positively associated with the increased levels of inflammation (P < 0.001). A significant indirect effect of inflammatory markers (neutrophil count and systemic inflammatory response index (SIRI)) with H. pylori infection on all-cause mortality through PhenoageAccel was found, and the proportions mediated were 50.0% and 49.1%, respectively.

CONCLUSION

The elevation of blood inflammatory markers is positively associated with an increased risk of all-cause mortality in H. pylori infection among U.S. population, and accelerated biological aging might be one of its biological mechanisms.

Triglyceride-glucose index and mortality risks in Helicobacter pylori-infected patients: a national cohort study

BACKGROUND

While Helicobacter pylori (H. pylori) infection is associated with insulin resistance and higher mortality, research on insulin resistance indices and outcomes in H. pylori-infected patients is scarce. This study examines the association between the triglyceride-glucose (TyG) index, an insulin resistance marker, and all-cause and cardiovascular mortality in these patients.

METHODS

This study analyzed NHANES 1999-2000 data to assess the association between the TyG index and all-cause and cardiovascular mortality in H. pylori-infected patients using weighted Cox models and restricted cubic spline analysis.

RESULTS

Among 627 participants with a median follow-up of 20.8 years, 108 all-cause and 28 cardiovascular deaths occurred. Cox models showed that TyG was linked to a hazard ratio (HR) of 1.70 for all-cause mortality (95% CI: 1.23-2.34, P < 0.01) and an HR of 2.90 for cardiovascular mortality (95% CI: 1.91-4.42, P < 0.001). Restricted cubic spline analysis confirmed a linear relationship between the TyG index and both mortality risks. Stratified analyses showed that this relationship was significantly associated in most subgroups, but there was no significant interaction.

CONCLUSION

Higher TyG index is strongly linked to increased risks of both all-cause and cardiovascular mortality in H. pylori-infected patients.

Association between Helicobacter pylori infection, serum thyroid-stimulating hormone, and thyroxine in the National Health and Nutrition Examination Survey 1999-2000

Background

Helicobacter pylori has been increasingly implicated in extra-gastric diseases. Current evidence regarding the association between serum thyroid-stimulating hormone (TSH), thyroxine (T4), and H. pylori infection remains inconclusive. Consequently, this study aimed to explore the correlation between TSH and T4 levels and H. pylori infection in a US-based population sample.

Methods

Data from the US National Health and Nutrition Examination Survey (NHANES), comprising 971 participants aged 30-85 years from 1999 to 2000, were analyzed. Binary logistic regression was employed to analyze the correlation between H. pylori and TSH and T4 levels. The impact of TSH and T4 on H. pylori infection was further assessed using restricted cubic spline (RCS) analysis. In addition, subgroup analyses stratified by sex and age were conducted.

Results

Subjects with H. pylori seropositivity demonstrated lower serum TSH levels and higher serum T4 levels compared to those with H. pylori seronegativity. A significant positive correlation was identified between H. pylori seropositivity and T4 levels with increasing quartiles of hormonal levels in both univariate regression models (Q4 vs. Q1: OR = 1.483; 95% CI, 1.033-2.129) and multivariate regression models (Q4 vs. Q1: OR = 1.004; 95% CI, 0.981-1.026). Conversely, a negative correlation was observed between H. pylori seropositivity and TSH levels with increasing quartiles of hormonal levels in univariate regression models (Q4 vs. Q1: OR = 0.579; 95% CI, 0.403-0.831) and in multivariate regression models (Q4 vs. Q1: OR = 0.580; 95% CI, 0.389-0.866). In stratified analyses, the adjusted association of serum T4 levels with H. pylori seropositivity was statistically significant among men (T4: Q4 vs. Q1: OR = 2.253; 95% CI, 1.311-3.873), age over 68 years in TSH levels (Q4 vs. Q1: OR = 0.434; 95% CI, 0.206-0.911), and age 41-54 years in T4 levels (Q4 vs. Q1: OR = 4.965; 95% CI, 2.071-11.903). RCS analysis revealed a non-linear relationship between TSH levels and H. pylori infection. Notably, when TSH < 0.98 IU/ml, the likelihood of H. pylori infection significantly increased.

Conclusions

Lower TSH and higher T4 levels were associated with H. pylori infection, particularly among men and elderly individuals.

Association between non-insulin-based insulin resistance surrogate makers and Helicobacter pylori infection: a population-based study

BACKGROUND

Current evidence on the associations between insulin resistance (IR) and Helicobacter pylori (H. pylori) infection remains limited. This study aimed to investigate the association between non-insulin-based surrogate markers of IR, including the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (METS-IR), and H. pylori infection in U.S.

POPULATIONS

METHODS

This cross-sectional study involving 939 U.S. participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2000. The associations between three IR surrogate markers and H. pylori infection were respectively investigated using logistic regression model, restricted cubic spline (RCS) curve and subgroup analysis.

RESULTS

Three IR surrogate markers levels were significantly elevated in H. pylori infection participants. There was a positive association between three IR surrogate markers and H. pylori infection, even after adjusting for potential confounding variables by three different models. In subgroup analysis, the adjusted association between three IR surrogate markers and H. pylori infection were more likely to be observed in female and Non-Hispanic White. Additionally, the RCS curve revealed a positive linear correlation between TyG index and H. pylori infection across all three models, and between METS-IR and H. pylori infection in Model 3. However, a positive nonlinear correlation was observed between TG/HDL-C ratio and H. pylori infection in all three models.

CONCLUSIONS

These findings suggest that non-insulin-based IR surrogate markers including TyG index, TG/HDL-C ratio, and METS-IR were all positively associated with H. pylori infection. These markers may serve as the potential indicators for identifying the risk of H. pylori infection in U.S.

POPULATIONS

CLINICAL TRIAL NUMBER

Not applicable.

The association between helicobacter pylori infection and Triglyceride-Glucose (TyG) index in US adults: A retrospective cross-sectional study

BACKGROUND

The Triglyceride-glucose (TyG) index is a marker for insulin resistance and metabolic syndrome, while Helicobacter pylori is linked to gastrointestinal diseases and may affect metabolic risks. This study examined the association between the TyG index and H. pylori infection in adults.

METHODS

Data from 3797 participants in the NHANES 1999-2000 cycle were analyzed. The relationship between the TyG index and H. pylori infection was assessed using multivariate logistic regression and a two-piecewise logistic model to explore non-linear effects. Subgroup analyses were conducted based on age, sex, glucose levels, BMI, and CKD.

RESULTS

A linear association between the TyG index and H. pylori infection was found. Subgroup analyses revealed significant interactions with a few variables.

CONCLUSIONS

This study indicates a linear relationship between the TyG index and H. pylori infection, suggesting metabolic influences on H. pylori infection and potential for targeted interventions in at-risk groups.

Relationships among Helicobacter pylori seropositivity, the triglyceride-glucose index, and cardiovascular disease: a cohort study using the NHANES database

BACKGROUND

Helicobacter pylori (H. pylori), a widely prevalent pathogen that can be cured through relatively simple medical methods, is thought to be potentially associated with the risk of cardiovascular diseases (CVD), although controversy remains. Currently, it is unclear whether the triglyceride-glucose index (TGI), a classic indicator of insulin resistance, influences the relationship between H. pylori infection and CVD. The present work explored the relationships between H. pylori seropositivity, the TGI and CVD, and the potential effect of TGI in this association.

METHODS

In this cross-sectional and cohort study, data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES (1999-2000) were used. The effects of the TGI, H. pylori seropositivity, and their interaction on the risk of CVD were assessed using logistic regression models. The hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality (ACM) were calculated using the Cox proportional hazards model. Restricted cubic spline (RCS) curves were employed to investigate potential non-linear or linear relationships among the TGI, H. pylori seropositivity, occurrence of CVD, and ACM. Mediation analyses were employed to assess the potential effects of H. pylori seropositivity and TGI on the risk of CVD and mortality.

RESULTS

Of the 9,399 participants, 4,488 (47.75%) were H. pylori-immunoglobulin G (IgG)-positive, and 3,934 (41.86%) were diagnosed with CVD. In the general population, participants with a TGI ≥ 75th percentile who were positive for H. pylori-IgG antibody had the highest risk of developing CVD (odds ratio = 1.487; 95% CI: 1.088-2.033). Among patients with CVD, those with a TGI ≥ 75th percentile & positive for H. pylori-IgG antibody were at a higher ACM risk (HR = 1.227; 95% CI: 1.009-1.491). H. pylori exhibited a significant mediating effect on CVD occurrence (Pindir = 0.004) and mortality (Pindir = 0.004) via the TGI.

CONCLUSIONS

H. pylori seropositivity may indirectly elevate the risk of CVD and mortality via the TGI. Combining the patient's H. pylori serological status with their TGI could enhance the predictive ability for CVD occurrence and related mortality. Therefore, the clinical practice of screening for and eradicating H. pylori in CVD patients may be anticipated.

Association of oxidative balance score with Helicobacter pylori infection and mortality among US population

BACKGROUND

Antioxidant and pro-oxidant dietary patterns and lifestyle changes have been considered to play a crucial role in Helicobacter pylori (H. pylori) infection. We conducted this study to investigate the underlying association between oxidative balance score (OBS) and H. pylori infection in the US population.

METHODS

This was a cross-sectional study according to data from the National Health and Nutrition Examination Survey (1999-2000), and included individuals with complete information about dietary intake and H. pylori serologic testing results. In the present study, we used multivariate logistic regression analysis, smoothed curve fitting, subgroup analyses, and Cox proportional hazards modeling based on demographic and clinical variables to examine the relationship between OBS and H. pylori infection.

RESULTS

A total of 3413 individuals participated in our analysis with an average age of 32.31 years. The prevalence of H. pylori infection in the study population was 29.77%. By performing smooth curve fitting analysis, we observed an approximately linear relationship between OBS and H. pylori infection, indicating that lower OBS was associated with higher risk of H. pylori infection, especially in over 60 years of age and non-Hispanic white populations. All-cause mortality was also found lower in individuals with higher OBS levels.

CONCLUSION

In the US population, increased levels of OBS were associated with a reduced risk of H. pylori infection and decreased all-cause mortality. More and further work is still needed to elucidate the precise mechanism of the association between OBS and H. pylori infection.

Additive impact of diabetes and Helicobacter pylori infection on all-cause mortality, diabetic mortality, and cardiovascular mortality: a longitudinal nationwide population-based study

BACKGROUND

Diabetes mellitus (DM) and Helicobacter pylori infection (HPI) pose increasing public health challenges in aging societies, sharing common pathophysiological mechanisms, and linked to significant health risks. Our study examines their respective impacts on all-cause and cardiovascular mortalities in a comprehensive longitudinal population-based analysis.

METHODS

The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) database conducted between 1999 and 2019, which included information on Diabetes mellitus status and Helicobacter pylori infection status. Mortality data were obtained from the same database mentioned above.

RESULTS

Among the 2719 participants, 1362 (50.1%) were free of both diabetes mellitus (DM) and Helicobacter pylori infection (HP) (DM -/HP -), 140 (5.1%) had DM alone (DM +/HP -), 1011 (37.2%) had HP alone (DM -/HP +), and 206 (7.6%) had both DM and HP (DM +/HP +). Compared to the DM -/HP - group, the DM +/HP - and DM + /HP + groups demonstrated increased all-cause mortality with adjusted hazard ratios (HRs) of 1.40 (95% [CI] 1.07-1.78) and 1.46 (95% CI 1.15-1.84), respectively. For diabetic mortality, DM +/HP- group and DM + /HP + group showed increased HR of 6.30 (95% CI 1.30-30.43) and 8.56 (95% CI 1.98-36.94), respectively. For cardiovascular mortality, the DM + /HP- group and DM + /HP + group exhibited increased HR of 1.75 (95% CI 1.14-2.69) and 1.98 (95% CI 1.40-2.79), respectively. The DM + /HP + cohort displayed the highest risk of overall mortality (p for trend = 0.003), diabetic mortality (p for trend < 0.0001), an6d cardiovascular mortality (p for trend < 0.0001).

CONCLUSIONS

The concurrent presence of DM and Helicobacter pylori infection significantly amplifies the risk of all-cause, cardiovascular, and diabetic mortality. Individuals with either condition may necessitate heightened management to prevent the onset of the other ailment and reduce mortality rates.

Obesity, abdominal obesity, metabolic obesity phenotypes, and Helicobacter pylori infection: results from NHANES 1999-2000

BACKGROUND

Recent studies on the association between Helicobacter pylori (H. pylori) infection and obesity have reported conflicting results. Therefore, the purpose of our study was to investigate the association of obesity, abdominal obesity, and metabolic obesity phenotypes with H. pylori infection.

METHODS

A cross-sectional study of 1568 participants aged 20 to 85 was conducted using the National Health and Nutrition Examination Survey (NHANES) cycle 1999-2000. Logistic regression models were employed to evaluate the association of general obesity as defined by body mass index (BMI), abdominal obesity as defined by waist circumference (WC) and waist-height ratio (WHtR), and metabolic obesity phenotypes with H. pylori seropositivity. Subgroup analyses stratified by age were conducted to explore age-specific differences in this association.

RESULTS

After grouping individuals according to their WHtR, the prevalence rate of WHtR ≥ 0.5 in H. pylori-seropositive participants was significantly higher than that in H. pylori-seronegative participants (79.75 vs. 68.39, P < 0.001). The prevalence of H. pylori seropositivity in non-abdominal obesity and abdominal obesity defined by WHtR was 24.97% and 31.80%, respectively (P < 0.001). In the subgroup analysis, the adjusted association between abdominal obesity, as defined by the WHtR, and H. pylori seropositivity was significant in subjects aged < 50 years (OR = 2.23; 95% CI, 1.24-4.01; P = 0.01) but not in subjects aged ≥ 50 years (OR = 0.84; 95% CI, 0.35-1.99; P = 0.66). Subjects older than 50 years old had an OR (95% CI) for metabolically healthy obesity of 0.04 (0.01-0.35) compared with the control group. H. pylori seropositivity was consistently not associated with obesity as defined by BMI.

CONCLUSIONS

Abdominal obesity, as defined by the WHtR, was associated with H. pylori infection in subjects aged ≤ 50 years.

Association of dietary inflammatory index with helicobacter pylori infection and mortality among US population

BACKGROUND

Limited research has been conducted on the potential relationship between the dietary inflammation index (DII) and mortality, particularly in individuals with Helicobacter pylori (H. pylori) infection. This study aimed to investigate the association between the DII and H. pylori infection, as well as their respective impacts on all-cause mortality in a cohort of individuals with or without H. pylori infection.

METHODS

Data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) were utilized for this study, with a final of 4370 participants included. Both univariable and multivariable-adjusted logistic regression analyses were employed to explore the relationship between H. pylori infection and pertinent covariates. Cox regression analysis, as well as restricted regression cubic spline analysis, were utilized to assess the association between DII and all-cause mortality among individuals with or without H. pylori infection.

RESULTS

The findings demonstrated a positive correlation between DII scores and H. pylori infection, even after adjusting for potential confounding factors. Moreover, higher DII scores were significantly associated with an elevated risk of mortality exclusively in individuals with H. pylori infection, while no such association was observed in the uninfected population. Additional analysis using restricted cubic spline modeling revealed a positive linear relationship between DII scores as a continuous variable and the adjusted risk of all-cause mortality specifically in H. pylori-infected patients.

CONCLUSION

The results of this study indicated that DII was positively correlated with an increased risk of H. pylori infection and was associated with a heightened risk of all-cause mortality solely in individuals with H. pylori infection. Consequently, DII might serve as a useful tool for risk stratification in the H. pylori-infected population among U.S. adults. Further research is warranted to elucidate the underlying mechanisms and potential clinical implications of these findings.

Atrophic Gastritis and Autoimmunity: Results from a Prospective, Multicenter Study

Despite a global decrease, gastric cancer (GC) incidence appears to be increasing recently in young, particularly female, patients. The causal mechanism for this "new" type of GC is unknown, but a role for autoimmunity is suggested. A cascade of gastric precancerous lesions, beginning with chronic atrophic gastritis (CAG), precedes GC. To test the possible existence of autoimmunity in patients with CAG, we aimed to analyze the prevalence of several autoantibodies in patients with CAG as compared to control patients. Sera of 355 patients included in our previous prospective, multicenter study were tested for 19 autoantibodies (anti-nuclear antibodies, ANA, anti-parietal cell antibody, APCA, anti-intrinsic factor antibody, AIFA, and 16 myositis-associated antibodies). The results were compared between CAG patients (n = 154), including autoimmune gastritis patients (AIG, n = 45), non-autoimmune gastritis patients (NAIG, n = 109), and control patients (n = 201). ANA positivity was significantly higher in AIG than in NAIG or control patients (46.7%, 29%, and 27%, respectively, p = 0.04). Female gender was positively associated with ANA positivity (OR 0.51 (0.31-0.81), p = 0.005), while age and H. pylori infection status were not. Myositis-associated antibodies were found in 8.9% of AIG, 5.5% of NAIG, and 4.4% of control patients, without significant differences among the groups (p = 0.8). Higher APCA and AIFA positivity was confirmed in AIG, and was not associated with H. pylori infection, age, or gender in the multivariate analysis. ANA antibodies are significantly more prevalent in AIG than in control patients, but the clinical significance of this finding remains to be established. H. pylori infection does not affect autoantibody seropositivity (ANA, APCA, AIFA). The positivity of myositis-associated antibodies is not increased in patients with CAG as compared to control patients. Overall, our results do not support an overrepresentation of common autoantibodies in patients with CAG.

Association between serum vitamin D levels and Helicobacter pylori cytotoxic-associated gene A seropositivity: a cross-sectional study in US adults from NHANES III

OBJECTIVE

To assess the association of serum vitamin D (VD) levels and Helicobacter pylori (H. pylori) cytotoxic-associated gene A (CagA) seropositivity, and further explore potential effect modifiers in this association.

DESIGN

Cross-sectional study.

SETTING

Data from phase I of the National Health and Nutrition Examination Survey (NHANES III, 1988-1991) led by the Center for Disease Control and Prevention.

PARTICIPANTS

A total of 3512 US adults (≥20 years) with both serum VD levels and H. pylori CagA antibody data from NHANES III were included in the analysis.

METHODS

VD deficiency was defined as serum 25(OH)D concentrations<20 ng/mL. Logistic regression models were used to assess the association of serum VD levels and H. pylori CagA seropositivity (VD-Hp CagA+), and stratification analyses were used to explore potential effect modifiers.

RESULTS

There was no significant association of VD-Hp CagA+ in the general population. But serum 25(OH)D concentrations were associated with H. pylori CagA+ in non-Hispanic whites (adjusted OR=1.02, 95% CI: 1.00 to 1.03), other races/ethnicities (adjusted OR=1.08, 95% CI: 1.01 to 1.06), populations born in other countries (adjusted OR=1.09, 95% CI: 1.04 to 1.15) or occasional drinkers (adjusted OR=0.93, 95% CI: 0.88 to 0.99). VD deficiency was associated with H. pylori CagA+ in non-Hispanic whites (adjusted OR=0.69, 95% CI: 0.53 to 0.92), populations born in other countries (adjusted OR=0.47, 95% CI: 0.25 to 0.89), non-drinkers (adjusted OR=0.80, 95% CI: 0.65 to 0.99), occasional drinkers (adjusted OR=2.53, 95% CI: 1.06 to 6.05), population with first quartile level of serum ferritin (adjusted OR=0.70, 95% CI: 0.51 to 0.96) or fourth quartile level of serum folate (adjusted OR=0.63, 95% CI: 0.46 to 0.87).

CONCLUSIONS

Racial/ethnic differences and different serum ferritin or serum folate levels may be effect modifiers for the association of VD-Hp CagA+.

Hygiene Hypothesis Indicators and Prevalence of Antinuclear Antibodies in US Adolescents

Autoimmunity prevalence, as measured by antinuclear antibodies (ANA), is increasing in U.S. adolescents. Improved hygiene and cleaner environments in childhood may reduce exposure to infections and other immune challenges, resulting in improper immune responses to later-life exposures. We examined associations of hygiene hypothesis indicators, including asthma, allergies, and antibodies to infectious agents, with ANA prevalence, measured by HEp-2 immunofluorescence, in adolescents (aged 12-19 years) over a 25-year time span in the National Health and Nutrition Examination Survey (NHANES) (N=2,709), adjusting for age, sex, race/ethnicity, body mass index, education and survey cycle, overall and within individual time periods, using logistic regression. Prevalence of ANA in adolescents increased from 5.0% in 1988-1991 to 12.8% in 2011-2012. ANA were positively associated with diagnosis of asthma in early childhood (OR: 2.07, CI: 1.09-3.99) and the effect estimate for current hay fever was elevated but not statistically significant (OR: 1.55, CI: 0.85-2.84). Fewer than 2% of those with ANA in 1988-1991 had been diagnosed with asthma, compared with 18% in 1999-2000, and 27% in 2003-2004 and 2011-2012. ANA trended negatively with Helicobacter pylori antibodies (OR: 0.49, CI: 0.24-0.99). ANA may be useful as an additional indicator of inadequate immune education in adolescence, a critical period of growth and development.

Association between Helicobacter pylori infection and serum thyroid stimulating hormone in the National Health and Nutrition Examination Survey 1999-2000

OBJECTIVE

Current evidence on the associations between plasma thyroid stimulating hormone and Helicobacter pylori infection is conflicting. Therefore, our study aimed to examine TSH in relation to H. pylori infection.

METHODS

Based on the US National Health and Nutrition Examination Survey (NHANES) 1999-2000, a cross-sectional study was conducted with 948 participants aged 30 to 85 years. The associations between H. pylori seropositivity and TSH were evaluated using binary logistic regression models. A subgroup analysis stratified by sex, age, and body mass index was conducted.

RESULTS

A higher serum TSH level was found in subjects with H. pylori seropositive than in subjects with H. pylori seronegative. A significant positive association was found between H. pylori seropositivity and TSH with increasing quartiles of hormonal levels in univariate regression models (Q4 vs Q1: OR = 1.659; 95% CI, 1.152-2.389) and in multivariate regression models (Q4 vs Q1: OR = 1.604; 95% CI, 1.087-2.367). In stratified analyses, the adjusted association of serum TSH with H. pylori seropositivity was statistically significant in male (Q4 vs Q1: OR = 1.894; 95% CI, 1.109-3.235), normal BMI (Q4 vs Q1: OR = 1.894; 95% CI, 1.109-3.235), overweight (Q4 vs Q1: OR = 2.124; 95% CI, 1.047-4.308);, obese (Q4 vs Q1: OR = 0.429; 95% CI, 0.220-0.837), and age over 60 years (Q4 vs Q1: OR = 1.999; 95% CI, 1.118-3.575).

CONCLUSION

High TSH levels were associated with H. pylori infection, especially among male, overweight and elderly adults.

Helicobacter pylori and its association with autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis and Sjögren syndrome

Helicobacter pylori (H. pylori) is a gram-negative bacterium that adapts to the gastric mucosa and provokes symptoms associated with gastritis. Chronic H. pylori infection in patients with a genetic predisposition can trigger autoimmune diseases due to the immune interaction of cellular and humoral responses. Infections are a triggering factor for systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and Sjögren syndrome (SS), although the association between H. pylori and these diseases is unclear. Therefore, we reviewed this interaction and its clinical importance.

Protective effect of oral contraceptive against Helicobacter pylori infection in US adult females: NHANES 1999-2000

Recently, the antibacterial properties of oestrogen and progestogen were discovered. The aim of this study was to find the cross-sectional association between oral contraceptive use and Helicobacter pylori seroprevalence. Data were obtained from the US National Health and Nutrition Examination Survey (NHANES). The H. pylori immunoglobulin G (IgG) enzyme-linked immunosorbent assays were used to categorise participants as seropositive or seronegative. The study population included 799 female participants who had information on H. pylori seroprevalence and all other covariates and had not been taking any medications (except oral contraceptives). The bivariate Rao-Scott chi-square test indicated a significant association between H. pylori seroprevalence and contraceptive use (P < 0.01). The variables of race, education, poverty income ratio, smoking, and blood lead and cadmium levels were also significantly associated with H. pylori seroprevalence (P < 0.01). Multiple logistic regression analysis of the age-adjusted model revealed that contraceptive users are 65% less likely of being H. pylori seropositive as compared to non-contraceptive users (odds ratio (OR): 0.35, 95% confidence interval (CI): 0.18-0.68). This association is stronger with the final multivariate model (OR: 0.46, 95% CI: 0.23-0.89). Conclusions: This finding reveals the potential protective effect of oral contraceptives against H. pylori infection and serves as a foundation study for further investigations.