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Gao X, Jia Y, Xu H, Li Y, Zhu Q, Wei C, Hou J, Li D, Wang W, Li Z, Guo R, Jia J, Wu Y, Wei Z, Qi X, Li Y. Association between serum pepsinogen and atherosclerotic cardiovascular disease. Nutr Metab Cardiovasc Dis 2021; 31:169-177. [PMID: 33127250 DOI: 10.1016/j.numecd.2020.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Serum pepsinogens (PGs) are biomarkers for gastric mucosal damage and have been reported to be associated with atherosclerosis. Its correlation with atherosclerotic cardiovascular disease (ASCVD) is still unknown. This study aimed to explore the association between serum PGs and ASCVD for providing physicians with an integrative picture to make rational plans in the diagnosis and treatment of ASCVD. METHODS AND RESULTS The concentrations of serum PGs and their distributions between ASCVD and non-ASCVD were compared by non-parametric test, Chi-squared test and Fisher exact test. The correlation between variables was analyzed by Spearman's correlation test. The association of serum PGs with ASCVD was analyzed by the binary logistic regression and two-piecewise linear regression. A total of 8355 recruited cases were eligible for the study. The concentrations of serum PGs were significantly different between the ASCVD and non-ASCVD groups (P = 0.025, P < 0.001). The lower PGI and PGR levels were significantly correlated with a high risk of ASCVD presence after adjustment for 26 potential covariates. Moreover, there was a linear relationship between the high level of PGII and the high risk of ASCVD [adjusted OR = 1.16 (1.00, 1.37), P = 0.07]. A nonlinear relationship of PGI/PGR and ASCVD (P = 0.08/<0.001) was also revealed. The risk of ASCVD increased with a range of log PGI ≥2.13 (PGI≥131 ng/mL) [adjusted OR = 4.67 (1.00, 23.17)], and decreased with a range of log PGR ≥0.22 (1.65) [adjusted OR = 0.59 (0.48, 0.74), P < 0.001]. CONCLUSIONS Serum PGI and PGR are nonlinearly correlated with ASCVD, while PGII is linearly correlated with ASCVD. Among all PGs, PGR may serve as a reliable biomarker for ASCVD.
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Affiliation(s)
- Xiaoling Gao
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China.
| | - Yanjuan Jia
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Hui Xu
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Yonghong Li
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Qing Zhu
- The Medical Department, Sichuan University West China Hospital, Chengdu, 610000, China
| | - Chaojun Wei
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jinxia Hou
- The Clinical Laboratory Centre, Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Dehong Li
- The Clinical Laboratory Centre, Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Wanxia Wang
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Zhenhao Li
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Rui Guo
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Jing Jia
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Yu Wu
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Zhenhong Wei
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Xiaoming Qi
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Yuanting Li
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, China; The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, Lanzhou, 730000, China
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Magalhães P, Zürbig P, Mischak H, Schleicher E. Urinary fetuin-A peptides as a new marker for impaired kidney function in patients with type 2 diabetes. Clin Kidney J 2020; 14:269-276. [PMID: 33564428 PMCID: PMC7857838 DOI: 10.1093/ckj/sfaa176] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background The hepatokine fetuin-A, released by the human liver, promotes pro-inflammatory effects of perivascular fat. The involvement of inflammation in type 2 diabetes mellitus (T2DM) can affect the kidney and contribute to the development of diabetic kidney disease. Therefore we examined the association of urinary fetuin-A protein fragments with renal damage in T2DM patients. Methods Urinary peptides of 1491 individuals using proteome data available from the human urine proteome database were analysed. Prediction of proteases involved in urinary peptide generation was performed using the Proteasix tool. Results We identified 14 different urinary protein fragments that belong to the region of the connecting peptide (amino acid 301–339) of the total fetuin-A protein. Calpains (CAPN1 and CAPN2), matrix metalloproteinase and pepsin A-3 were identified as potential proteases that were partially confirmed by previous in vitro studies. Combined fetuin-A peptides (mean of amplitudes) were significantly increased in T2DM patients with kidney disease and to a lesser extent with cardiovascular risk. Furthermore, fetuin-A peptide levels displayed a significant negative correlation with baseline estimated glomerular filtration rate (eGFR) values (r = −0.316, P < 0.0001) and with the slope (%) of eGFR per year (r = −0.096, P = 0.023). A multiple regression model including fetuin-A peptide and albuminuria resulted in a significantly improved correlation with eGFR (r = −0.354, P < 0.0001) compared with albuminuria, indicating an added value of this novel biomarker. Conclusions The urinary proteome analysis demonstrated the association of fetuin-A peptides with impaired kidney function in T2DM patients. Furthermore, fetuin-A peptides displayed early signs of kidney damage before albuminuria appeared and therefore can be used as markers for kidney disease detection.
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Affiliation(s)
| | | | - Harald Mischak
- Mosaiques Diagnostics GmbH, Hannover, Germany.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Erwin Schleicher
- Institute for Clinical Chemistry and Pathobiochemistry/Central Laboratory, University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research, Tübingen; Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany
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Zendehdel A, Roham M. Role of Helicobacter pylori infection in the manifestation of old age-related diseases. Mol Genet Genomic Med 2020; 8:e1157. [PMID: 32067423 PMCID: PMC7196471 DOI: 10.1002/mgg3.1157] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/10/2019] [Accepted: 01/11/2020] [Indexed: 12/13/2022] Open
Abstract
Helicobacter pylori is one of the most prevalent infection worldwide. It affects individuals of different age groups. Elderly people tend to resist eradication treatment and worsening of infection can lead to several gastric and non-gastric pathologies. Aging-associated cellular and molecular alteration can increase the risk of other pathologies such as osteoporosis, Alzheimer's disease, Parkinson's disease, respiratory and renal dysfunction, and cancer in geriatric patients, more than other age groups. This review article highlights some of the most common old age diseases and the role of H. pylori infection as a risk factor to worsen the conditions, presented by the molecular evidences of these associations. These studies can help clinicians to understand the underlying pathogenesis of the disease and identify high-risk patients, aiding clearer diagnosis and treatment.
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Affiliation(s)
- Abolfazl Zendehdel
- Department of Geriatric MedicineZiaeian HospitalTehran University of Medical SciencesTehranIran
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Pyo JH, Lee H, Choi SC, Cho SJ, Choi YH, Min YW, Min BH, Lee JH, Yoo H, Kim K, Kim JJ. Lack of Association between Past Helicobacter pylori Infection and Diabetes: A Two-Cohort Study. Nutrients 2019; 11:nu11081874. [PMID: 31409000 PMCID: PMC6723734 DOI: 10.3390/nu11081874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) may be involved in diabetes and other insulin-related processes. This study aimed to investigate the associations between H. pylori infection and the risks of type 2 diabetes, impaired glucose tolerance (IGT), diabetic nephropathy, and poor glycemic control. We retrospectively evaluated 16,091 subjects without diabetes at baseline who underwent repeated health examinations. Subjects were categorized according to whether they were seropositive and seronegative for H. pylori infection. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. The serological results were validated using an independent cohort (n = 42,351) based on a histological diagnosis of H. pylori infection. During 108,614 person-years of follow-up, 1338 subjects (8.3%) developed newly diagnosed diabetes, although the cumulative incidence of diabetes was not significantly related to serological H. pylori status. The multivariate Cox proportional-hazards regression models revealed that H. pylori seropositivity was not significantly associated with diabetes (HR: 1.01, 95% CI: 0.88–1.16; p = 0.854), IGT (HR: 0.98, 95% CI: 0.93–1.04; p = 0.566), diabetic nephropathy (HR: 0.99, 95% CI: 0.82–1.21; p = 0.952), or poor glycemic control (HR: 1.05, 95% CI: 0.90–1.22; p = 0.535). Similarly, histopathological findings of H. pylori infection were not significantly associated with diabetes (p = 0.311), diabetic nephropathy (p = 0.888), or poor glycemic control (p = 0.989). The findings from these large Korean cohorts indicate that there does not appear to be a role for past H. pylori infection in the development of diabetes, IGT, diabetic nephropathy, or poor glycemic control.
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Affiliation(s)
- Jeung Hui Pyo
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
| | - Sung Chul Choi
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Soo Jin Cho
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Yoon-Ho Choi
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Jun Haeng Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Heejin Yoo
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
| | - Jae J Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
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Cheng K, Yang Y, Hung H, Lin C, Wu C, Hung M, Sheu B, Ou H. Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection. J Diabetes Investig 2019; 10:1092-1101. [PMID: 30556347 PMCID: PMC6626959 DOI: 10.1111/jdi.12991] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/04/2018] [Accepted: 12/13/2018] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION Helicobacter pylori infection is associated with insulin resistance and glycemia in non-diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. MATERIALS AND METHODS A total of 549 diabetes patients were recruited for sequential two-step approach (immunoglobulin G [IgG] serology followed by 13 C-urea breath test [UBT]) to discriminate "active" (IgG+ and UBT+) from "non-active" (UBT- or IgG-) H. pylori infection, and "past" (IgG+ but UBT-) from "never/remote" (IgG-) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the "active" infection group, the differences in A1C changes between participants with and without 10-day eradication therapy were compared after 3 months. RESULTS Despite no between-group difference in A1C, the "active" infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P < 0.001) than the "non-active" infection group (n = 341). There were no differences in A1C and oral antidiabetic drug classes between "past" (n = 111) and "never/remote" infection groups (n = 230). Compared with the non-eradication group (n = 99), the eradication group (n = 98) had significant within-group (-0.17 ± 0.80%, P = 0.036) and between-group (-0.23 ± 0.10%, P = 0.024) improvements in A1C. CONCLUSIONS Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.
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Affiliation(s)
- Kai‐Pi Cheng
- Division of Endocrinology and MetabolismDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Yao‐Jong Yang
- Department of PediatricsNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Medicine College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Hao‐Chang Hung
- Division of Endocrinology and MetabolismDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Institute of Basic Medical SciencesCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Ching‐Han Lin
- Division of Endocrinology and MetabolismDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Institute of Clinical Medicine College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Chung‐Tai Wu
- Institute of Clinical Medicine College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Division of GastroenterologyDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Mei‐Hui Hung
- Department of NursingShu‐Zen Junior College of Medicine and ManagementKaohsiungTaiwan
| | - Bor‐Shyang Sheu
- Institute of Clinical Medicine College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Division of GastroenterologyDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Internal MedicineTainan HospitalMinistry of Health and WelfareTainanTaiwan
| | - Horng‐Yih Ou
- Division of Endocrinology and MetabolismDepartment of Internal MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
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Chen J, Xing Y, Zhao L, Ma H. The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis. J Diabetes Res 2019; 2019:3705264. [PMID: 31583248 PMCID: PMC6754895 DOI: 10.1155/2019/3705264] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The association between Helicobacter pylori infection and glycated hemoglobin A has been confirmed in many studies, but these conclusions are still contradictory and controversial. Therefore, we conducted a meta-analysis to resolve the problem of inconsistent results in diabetes. METHODS A comprehensive search was conducted on related researches published in PubMed, Embase, and China Academic Journal Full-text Database (CNKI) from the inception of each database to April 2019. Fixed or random effects model was used to pool the weighted mean difference with 95% confidence interval from individual studies. Subgroup and sensitivity analyses were also performed. Publication bias was estimated by funnel plot, Egger's test, and fail-safe numbers. RESULTS 35 studies with 4,401 participants with diabetes were included in the meta-analysis. Glycated hemoglobin A levels were elevated in patients with Helicobacter pylori infection compared with patients without Helicobacter pylori infection (WMD = 0.50, 95% CI: 0.28-0.72, p < 0.001). In subgroup analysis by the subtype of diabetes, there was a correlation between Helicobacter pylori infection and elevated glycated hemoglobin A in type 1 diabetes (I 2 = 74%, p < 0.001, WMD = 0.46, 95% CI: 0.12-0.80), and in type 2 diabetes (I 2 = 90%, p < 0.001, WMD = 0.59, 95% CI: 0.28-0.90, p < 0.001). In subgroup analysis by the study design, there was a correlation in cross-sectional study (I 2 = 89%, p < 0.001, WMD = 0.42, 95% CI: 0.16-0.69, p ≤ 0.003) and in case-control study (I 2 = 83%, p < 0.001, WMD = 0.39, 95% CI: 0.14-0.64, p ≤ 0.003). By different methods for detecting Helicobacter pylori, there was a correlation in the biopsy group (I 2 = 83%, p < 0.001, WMD = 0.6, 95% CI: 0.11-1.09, p ≤ 0.03) and in other groups of test methods (I 2 = 87%, p < 0.001, WMD = 0.37, 95% CI: 0.17-0.56, p < 0.001). Sensitivity analysis showed that our results were reliable, and no evidence of substantial publication bias was detected. CONCLUSION The meta-analysis might indicate a correlation between Helicobacter pylori infection and glycated hemoglobin A levels in diabetes.
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Affiliation(s)
- Jinhu Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
| | - Yuling Xing
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Liying Zhao
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital Shijiazhuang, Hebei 050051, China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, China
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Su W, Zhou B, Qin G, Chen Z, Geng X, Chen X, Pan W. Low PG I/II ratio as a marker of atrophic gastritis: Association with nutritional and metabolic status in healthy people. Medicine (Baltimore) 2018; 97:e10820. [PMID: 29768385 PMCID: PMC5976324 DOI: 10.1097/md.0000000000010820] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A low pepsinogen (PG) I/II ratio can be used to detect atrophic gastritis (AG). Recent research has found that the PG I/II ratio is associated with several nutritional and metabolic disorders. The aim of this study is to investigate the relationship between the PG I/II ratio and biochemical markers in a Chinese population.In total, 1896 participants in a gastric cancer screening program underwent a health screening test that included assessment of serum pepsinogens. Subjects with PG I/II < 3.0 were considered as having atrophic gastritis. Associations between the PG I/II ratio and biochemical markers reflecting glucose and lipid metabolism, liver, kidney and thyroid functions were evaluated using SPSS software version 20.The prevalence of atrophic gastritis was 5.3% and increased with age but did not differ between sexes. Albumin, ferritin, and total and direct bilirubin were significantly lower in patients with AG than in those without AG, whereas age, total bile acid, and amylase were significantly higher. Albumin, ferritin, and triglyceride correlated positively with the PG I/II ratio, while age, total bile acid, blood urea nitrogen, amylase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase correlated inversely with the PG I/II ratio. Logistic regression analysis demonstrated that age, total bile acid, total protein, and ferritin correlated independently with AG.Low PG I/II ratio is not only a marker of atrophic gastritis but also an indicator of nutritional and metabolic status. Special attention should be paid to the metabolism of iron, protein, and bile acid in patients with a low PG I/II ratio.
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Affiliation(s)
| | | | - Guangming Qin
- Department of Laboratory, Second Affiliated Hospital, School of Medicine, Zhejiang University
| | | | | | | | - Wensheng Pan
- Department of Gastroenterology
- Department of Gastroenterology and Endoscopy Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310009, China
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Bahadoran Z, Mirmiran P, Zarif-Yeaganeh M, Zojaji H, Azizi F. Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients. Endocrinol Metab (Seoul) 2015; 30:280-7. [PMID: 26435133 PMCID: PMC4595352 DOI: 10.3803/enm.2015.30.3.280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 10/26/2014] [Accepted: 11/13/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients. METHODS In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index. RESULTS The mean age of participants was 54±10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24±0.23 μg/mL and 9.9±9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (γ=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; γ=0.43, P<0.01), and triglycerides/HDL-C ratio (γ=-0.28, P<0.05) were observed. CONCLUSION Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.
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Affiliation(s)
- Zahra Bahadoran
- Nutrition and Endocrine Research Center and Obesity Research Center, Research Institute for Endocrine Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Tehran, Iran.
| | - Maryam Zarif-Yeaganeh
- Nutrition and Endocrine Research Center and Obesity Research Center, Research Institute for Endocrine Sciences, Tehran, Iran
| | - Homayoun Zojaji
- Research Center for Gastroenterology and Liver Disease, Department of Gastroenterology and Liver Diseases, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dong JZ, Li YX. Detection of Helicobacter pylori infection induced changes in pepsinogen Ⅰ/Ⅱ ratio for predicting organ injuries in patients with primary hypertension. Shijie Huaren Xiaohua Zazhi 2015; 23:2501-2506. [DOI: 10.11569/wcjd.v23.i15.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the value of detection of Helicobacter pylori (H. pylori) infection induced changes in pepsinogen (PG) Ⅰ/Ⅱ ratio in predicting organ injuries in patients with primary hypertension.
METHODS: Sixty-eight patients with primary hypertension were included. The correlations between triglycerides, total cholesterol, or high density lipoprotein and PG Ⅰ/Ⅱ ratio were analyzed. The changes in PG Ⅰ/Ⅱ ratio in patients with and without cardiopathy, hypertensive nephropathy, or fundus lesions were compared. The efficiency of PG Ⅰ/Ⅱ ratio in the diagnosis of cardiopathy, nephropathy, and retinopathy was evaluated by receiver operating characteristic (ROC) analysis.
RESULTS: Compared to patients without H. pylori infection, patients with H. pylori infection showed significantly increased triglycerides (190.6 mg/dL ± 72.1 mg/dL vs 141.4 mg/dL ± 56.8 mg/dL), total cholesterol (257.8 mg/dL ± 124.7 mg/dL vs 198.6 mg/dL ± 99.5 mg/dL), and decreased PG Ⅰ/Ⅱ ratio (8.2 ± 3.6 vs 12.4 ± 4.9) (P < 0.05). Triglycerides (r = -0.302) and total cholesterol (r = -0.395) were negatively correlated with PG Ⅰ/Ⅱ ratio (P < 0.05). The rates of H. pylori infection were significantly higher in patients with cardiopathy [81.6% (44/49) vs 40.8% (91/223)], hypertensive nephropathy [84.6% (44/52) vs 45.5% (100/220)], and fundus lesions [67.7% (84/124) vs 40.5% (60/148)] than in those without (P < 0.05). PG Ⅰ/Ⅱ ratio was significantly decreased in patients with cardiopathy (6.9 ± 2.6 vs 11.3 ± 3.2), hypertensive nephropathy (6.3 ± 1.7 vs 10.8 ± 3.4) and fundus lesions (7.4 ± 1.9 vs 12.2 ± 3.5) compared to patients without (P < 0.05). The areas under the ROC curves of PG Ⅰ/Ⅱ ratio for detecting cardiopathy, hypertensive nephropathy and fundus lesions were 0.811, 0.802 and 0.831, respectively.
CONCLUSION: PG Ⅰ/Ⅱ ratio decreases in primary hypertension patients with cardiopathy, hypertensive nephropathy or fundus lesions, suggesting that PG Ⅰ/Ⅱ ratio can be used to screen organ injuries in patients with primary hypertension.
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Horikawa C, Kodama S, Fujihara K, Yachi Y, Tanaka S, Suzuki A, Hanyu O, Shimano H, Sone H. Association of Helicobacter pylori infection with glycemic control in patients with diabetes: a meta-analysis. J Diabetes Res 2014; 2014:250620. [PMID: 24901007 PMCID: PMC4034768 DOI: 10.1155/2014/250620] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE. To assess the association between Helicobacter pylori (HP) infection and glycemic control in patients with diabetes through a meta-analytic approach. RESEARCH DESIGN AND METHODS. Electronic literature searches were conducted for cross-sectional studies that examined the hemoglobin A1c (A1C) level by whether patients with diabetes were or were not carriers of HP. Mean differences in A1C between groups with and without HP infection were pooled with a random-effects model. RESULTS. Thirteen eligible studies were included in this meta-analysis. Overall, the HP carriers did not have significantly higher A1C levels compared with HP noncarriers (mean difference (95% CI), 0.19% (-0.18 to 0.46), P = 0.16). When the analysis was limited to studies targeting patients with type 1 diabetes, there was also no significant difference in A1C (0.69% (-0.31 to 1.68), P = 0.18). CONCLUSIONS. There was insufficient evidence that HP infection worsened glycemic control in patients with diabetes.
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Affiliation(s)
- Chika Horikawa
- Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
- Department of Health Management Center, Mito Kyodo General Hospital, Ibaraki, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
- Department of Health Management Center, Mito Kyodo General Hospital, Ibaraki, Japan
| | - Yoko Yachi
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
| | - Shiro Tanaka
- Department of Clinical Trial, Design & Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan
| | - Akiko Suzuki
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
| | - Osamu Hanyu
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
| | - Hitoshi Shimano
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata 951-8510, Japan
- *Hirohito Sone:
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