Sex differences between Helicobacter pylori infection and cholesterol levels in an adult health checkup program

The influence of Helicobacter pylori infection on acute coronary syndrome and lipid metabolism in the Chinese ethnicity

Background

Acute coronary syndrome (ACS) patients frequently present a relatively high prevalence of Helicobacter pylori (H. pylori) infection. H. pylori was previously hypothesized to induce ACS through the regulation of lipid levels. However, the risk of H. pylori-induced ACS varies significantly among different ethnic groups, and the associations between H. pylori and lipid parameters remain unclear. This study aimed to systematically assess the risk of ACS in Chinese populations with H. pylori infection while also evaluating the effects of H. pylori on lipid parameters.

Materials and methods

A hospital-based case-control study involving 280 participants was conducted. Immunoblotting was used for the detection and genotyping of H. pylori. The associations between H. pylori and ACS, as well as lipid parameters, were analyzed via the chi-square test and a multiple logistic regression model.

Results

H. pylori infection significantly increased the risk of ACS among all participants (adjusted odds ratio (OR) = 4.04, 95% confidence interval (CI): 1.76-9.25, P < 0.05), with no associations with virulence factors (cytotoxin-associated gene A (CagA) or vacuole toxin geneA (VacA)). Subgroup analysis revealed a significant increase in the risk of ACS among the elderly population aged 56-64 years with H. pylori infection. Additionally, a substantial association was observed between H. pylori and acute myocardial infarction (AMI). No significant differences were found in lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and the LDL/HDL ratio, between individuals positive and negative for H. pylori infection. Similar results were observed between the ACS group and the control group.

Conclusions

Our study has demonstrated for the first time that H. pylori does not significantly impact lipid metabolism but increases the risk of ACS fourfold in the Chinese population (OR = 4.04, 95% CI: 1.76-9.25). Furthermore, the virulence factors of H. pylori (CagA and VacA) may not be involved in the mechanisms by which they promote the development of ACS. This finding provides additional evidence for the association between H. pylori and ACS among different ethnic groups and refutes the biological mechanism by which H. pylori affects ACS through lipid metabolism regulation. Regular screening for H. pylori and eradication treatment in elderly individuals and those at high risk for ACS may be effective measures for reducing the incidence of ACS. Future research should include multicenter randomized controlled trials and explore host genetics and the effects of H. pylori on the gut microbiota as potential biological pathways linking H. pylori and ACS.

Prevalence and predictors of Helicobacter pylori infection in asymptomatic individuals: a hospital-based cross-sectional study in Shenzhen, China

OBJECTIVE

Although a high Helicobacter pylori infection rate has been reported in dyspeptic patients, published data for the asymptomatic population are inadequate. We aimed to investigate the prevalence of H. pylori infection and the association between H. pylori infection diagnosed using the non-invasive 13C urea breath test (13C UBT) and risk factors in asymptomatic Chinese individuals.

METHODS

Healthy subjects who underwent hospital health examinations in the hospital health management department from September 2020 to September 2021 were consecutively enrolled. Anthropometric and biochemical characteristics were measured, and all subjects underwent 13C UBT. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection.

RESULTS

Of the 5007 participants included, the overall prevalence of H. pylori infection was 35.0% and was similar in men (35.5%) and women (34.2%). The prevalence of H. pylori increased by 84.8% in those aged ≥ 60 years compared with those aged < 30 years (P<0.001), and increased by 30.9% in the obese group compared with the normal weight groups (P=0.034). Fasting blood glucose (FBG) and albumin levels showed a significant association with the prevalence of H. pylori. The prevalence of H. pylori increased by 6.9% following each 1-unit increase in FBG (P=0.033) and decreased by 3.7% for each 1-unit increase in albumin (P=0.012). Moreover, the results of the age stratification showed that albumin level was negatively associated with the prevalence of H. pylori in participants aged < 50 years (OR=0.952, 95%CI: 0.921-0.985; P=0.005). However, the prevalence of H. pylori in participants aged ≥ 50 years increased by 66.6% in the impaired glucose group compared to the normal glucose group (P=0.003).

CONCLUSION

These findings suggest that detailed and strict weight and glucose management is crucial to reduce the prevalence of H. pylori infection. Management strategies should be identified and implemented with regard to these identified factors to reduce the notable economic and healthcare burden in China.

The association of Helicobacter Pylori infection with dyslipidaemia and other atherogenic factors in dyspeptic patients at St. Paul's Hospital Millennium Medical College

Background

Studies showed that more than half of Ethiopians were presumed to be chronically infected with H. pylori. Nowadays, evidence has come to the literature strongly suggesting the potential association between H. pylori and extra gastric disorders including atherosclerosis.

Objective

To assess the association of helicobacter pylori infection with dyslipidaemia and other atherogenic factors in dyspeptic patients at St. Paul's Hospital Millennium Medical College, from November 2019 to June 2020.

Materials and methods

This institution-based cross-sectional study was examining 346 dyspeptic patients at SPHMMC from November 2019 to June 2020. A structured questionnaire was used to collect socio-demography data and anthropometric measurement was taken. Biochemical parameters were measured in serum samples by using Cobas 6000 clinical chemistry analyzer. Data were coded and entered into a statistical package for social sciences (SPSS) version 23 for analysis. Risk factors were identified using logistic regression. Hence, a bivariate logistic regression analysis test was conducted and variables with a p < 0.25 were included in the multivariate logistic regression model. P-values ≤0.05 were considered as a cut point for statistical significance in the final model.

Results

An overall prevalence of dyslipidemia among study participants was 253 (73.12 %). Among those who tested positive for H. pylori, 119/174 (68.39 %) had dyslipidemia in at least one lipid profile, while 8 (4.60%) had dyslipidemia in all four lipid profiles. After adjusting for traditional dyslipidemia risk factors, age >45 (AOR 4.864, 95% CI 2.281-4.080, P < 0.001), systolic blood pressure >120mmHg (AOR 1.036, 95% CI 1.009-1.065, P = 0.036) and being H. Pylori seropositive (AOR 0.555, 95% CI 0.318-0.967, P = 0.038) were an independent predictors of dyslipidemia.

Conclusion

This study reported that more than two-thirds of the H. pylori seropositive groups had exhibited dyslipidemia in at least one lipid profile, which can accelerate the incidence of atherosclerosis process.

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

Obesity, as a major risk factor of metabolic syndrome (MetS), represents a pandemic, especially in Western societies, and is considered a risk factor for malignancies. Helicobacter pylori (Hp), is a definite carcinogen with global distribution. We aimed to investigate, for the first time in Switzerland, the main gastric mucosa premalignant histological lesions of bariatric patients in correlation with MetS components and Hp Infection (Hp-I). By reviewing retrospectively 94304 patient cases, a total of 116 eligible patients having undergone bariatric surgery were identified. The mean patient age was 48.66 years. Hp(+) patients were 24% (28/116). Presence of gastric mucosa atrophy was documented in 8/28 Hp(+) patients (29%) and (2/88) Hp(-) ones (2%) (p = 0.006). Gastric mucosa intestinal metaplasia was observed in 14/28 (50%) Hp(+) patients versus 3/88 (3.4%) of Hp(-) group (p < 0.0001). Hp(+) patients exhibited statistically higher arterial hypertension (p = 0.033). The homeostatic model of assessment insulin resistance was also statistically significantly higher for the Hp(+) group (p < 0.001). In a multivariate analysis, including arterial hypertension, gastric mucosa atrophy, and intestinal metaplasia as variables, statistical significance remained only for intestinal metaplasia (p = 0.001). In conclusion, Hp-I is associated with premalignant gastric mucosa histologic lesions and MetS components, including arterial hypertension and IR. Further large-scale prospective studies are required to confirm these findings.