Association of Helicobacter pylori infection with metabolic syndrome in aged Chinese females

Association between infection with Helicobacter pylori and metabolic syndrome among diabetic patients attending Jimma medical center in Jimma city, Ethiopia: a cross-sectional study

BACKGROUND

Previous studies have implicated the role of H. pylori infection in developing the metabolic syndrome. However, findings remain contradictory, and data from developing countries are scarce.

METHODS

We employed a cross-sectional study design to assess the relationship between H. pylori infection and metabolic syndrome among diabetic patients attending Jimma Hospital, Ethiopia. An interviewer-led questionnaire administered to study participants provided information on sociodemographic factors, and medical records were used to obtain medical history information. Metabolic parameters, including plasma glucose, triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), body-mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. H. pylori infection status was assessed using IgG Enzyme-linked Immunosorbent Assays (ELISA). The effect of H. pylori infection on metabolic syndrome and metabolic parameters was determined using multivariate linear and logistic regressions.

RESULTS

We found H. pylori infection status was positively but not significantly associated with metabolic syndrome (AOR = 1.507, 95% CI: 0.570-3.981, p = 0.408). When the analysis was restricted to individual metabolic parameters, H. pylori positivity was significantly associated with lower HDL-c and higher SB, respectively.

CONCLUSIONS

Our result confirms that individual metabolic parameters, not an overall metabolic syndrome, are significantly associated with H. pylori infection. Future studies should examine the relationship between H. pylori and metabolic syndrome, considering gastrointestinal conditions such as GERD, GU, and DU.

Metabolic syndrome and associated factors among H. pylori-infected and negative controls in Northeast Ethiopia: a comparative cross-sectional study

Background

The prevalence of metabolic syndrome (MetS) in patients infected with Helicobacter pylori, and the factors associated with it are not well understood. This study evaluates MetS and its associated factors among both H pylori-positive and H pylori-negative individuals in Northeast Ethiopia.

Methods

A cross-sectional study was conducted between 1 March 2022 to 30 May 2022. A semi-structured questionnaire was used to collect data on sociodemographic, behavioral, and clinical variables. A total of 228 subjects were randomly selected. Blood and stool samples were collected from each subject to measure fasting blood glucose and lipid profiles, and to identify H. pylori infection. Data were entered into Epi. Data 3.1 and analyzed using SPSS version 25. Logistic regression analysis and the Mann-Whitney U-test were performed to determine associated factors and compare median and interquartile ranges.

Results

Of the 228 participants, 114 were H. pylori positive, and 114 were H. pylori negative. Participants (50.9% female) ranged in age from 18 years to 63 years, with a median age of 31 (IQR, 22, 40) years. The overall prevalence of MetS among the participants was 23.2%. We found a statistically significant association between MetS and fasting blood glucose level (AOR, 15.965; 95% CI, 7.605-33.515, p<0.001). Furthermore, there was a statistically significant difference in the median serum levels of low-density lipoprotein cholesterol (p<0.001), triglycerides (p=0.036), systolic blood pressure (<0.001), and total cholesterol (p<0.001) between H. pylori-positive and H. pylori-negative participants.

Conclusion

MetS was prevalent among study participants. There was also a statistically significant association between fasting blood sugar and MetS. In addition, systolic blood pressure, total cholesterol, triglycerides, and low-density lipoprotein levels were significantly different between H. pylori-positive and H. pylori-negative individuals.

Recent research progress on the correlation between metabolic syndrome and Helicobacter pylori infection

Background

Globally, metabolic syndrome (MS) and Helicobacter pylori (HP) infection, which have gained an epidemic status, are major challenges to human health, society, and medical professionals. Recent studies have demonstrated that MS is closely related to HP infection. Additionally, HP is an important risk factor for gastric cancer. However, systematic reviews on HP are lacking. This review aimed to summarize and analyze the potential correlation of HP infection with MS and its components, as well as the underlying mechanism, to provide reference and strategies for clinical prevention and treatment.

Methodology

Previous studies examining the correlation between HP and MS since 1990 were retrieved from the PubMed, Web of Science, and Embase databases. The potential correlation between HP infection and MS and its components was comprehensively analyzed. The keywords "Helicobacter pylori," "HP," "metabolic syndrome," "hypertension," "obesity," "diabetes," or "dyslipidemia" were used in all fields. No language restrictions were imposed.

Results

MS was strongly correlated to HP infection. The inflammatory response and inflammatory factors produced during HP infection are important etiological factors for insulin resistance and MS. The co-occurrence of long-term chronic inflammation and immune dysfunction with MS may be the predisposing factor for HP infection. MS components, such as diabetes, hypertension, dyslipidemia, and obesity were also correlated with HP infection in one or both directions.

Conclusions

HP infection and MS may promote the pathogenesis of each other. The contribution of HP infection and MS to gastric cancer cannot be ruled out based on co-occurrence. The MS components diabetes and obesity may be bidirectionally correlated with HP infection.

Association between Helicobacter pylori infection and metabolic syndrome and its components

Background and aim

The association between Helicobacter pylori (H. pylori) infection and metabolic syndrome (MetS) has been studied previously; however, the results remain controversial, which could be partly due to the different criteria used for defining MetS. We adopted five MetS criteria to provide better understanding of the association between H. pylori infection and MetS.

Methods

Physical examination data of 100,708 subjects were obtained from January 2014 to December 2018. MetS was defined based on five criteria including: International Diabetes Federation (IDF), The Third Report of the National Cholesterol Education Program Expert Panel, Adult Treatment Panel III (ATP III), Joint Statement of International Multi-Societies (JIS), Chinese Diabetes Society (CDS), and the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 edition)(CDS DM). Multivariate logistic regression analysis was performed to elucidate the association between H. pylori infection and MetS and its components.

Results

The prevalence of MetS defined assessed using IDF, ATP III, JIS, CDS and CDS DM criteria was 15.8%, 19.9%, 23.7%, 8.7% and 15.4%, respectively. In males, the prevalence of MetS assessed using the five criteria in H. pylori-positive group was higher than that in negative-group; however, in females, same results were obtained using the three international criteria. In males, the prevalence of all MetS components was found to be higher in the H. pylori-positive group than those in the negative group; however, in females, only the prevalence of dyslipidemia and waist circumferences exhibited significant differences. Multivariate logistic regression analysis revealed that H. pylori infection in males was positively correlated with MetS. Additionally, H. pylori infection was found to be positively correlated with the waist circumference in the general population, and with hypertension and hyperglycemia in males.

Conclusions

H. pylori infection was found to be positively associated with MetS in males in China.

Long-term effect of the eradication of Helicobacter pylori on the hemoglobin A1c in type 2 diabetes or prediabetes patients

BACKGROUND/AIMS

The long-term effect of Helicobacter pylori eradication on the metabolic syndrome or diabetes are unclear. The aim of this study was to evaluate the effect of H. pylori eradication on glycemic control in type 2 diabetes mellitus (T2DM) or prediabetes mellitus (preDM).

METHODS

A total of 124 asymptomatic subjects with T2DM or preDM were divided into H. pylori-negative (n = 40), H. pylori-positive with non-eradicated (n = 34), and eradicated (n = 50) groups. We measured H. pylori status (culture, histology, and rapid urease test) and glycated hemoglobin A1c (A1C) levels and followed-up at the 1st year and the 5th year of follow-up.

RESULTS

The A1C levels significantly decreased in the eradicated group compared to the negative group and the non-eradicated groups (at the 1st year, p = 0.024; at the 5th year, p = 0.009). The A1C levels decreased in male, and/or subjects < 65 years of age in subgroup analyses (in male subjects, p = 0.047 and p = 0.020 at the 1st and the 5th year; in subjects < 65 years of age, p = 0.028 and p = 0.006 at the 1st and the 5th year; in male subjects < 65 years of age, p = 0.039 and p = 0.032 at the 1st and the 5th year). The eradication of H. pylori was related to the decrease in A1C values throughout the follow-up period, compared to the non-eradicated group (p = 0.017).

CONCLUSION

H. pylori eradication was related to the decreasing of A1C levels in patients with T2DM or preDM over a long-term follow-up period, especially in male and subjects < 65 years of age.

Helicobacter pylori Infection Acts as an Independent Risk Factor for Intracranial Atherosclerosis in Women Less Than 60 Years Old

Background: Studies show inconsistent results regarding the relationship between Helicobacter pylori (H. pylori) infection and stroke. The present study assessed a potential association between H. pylori infection and an important risk factor for stroke, intracranial atherosclerosis.

Methods: In total, 15,798 subjects with transcranial Doppler (TCD) and 13C-urea breath test (13C-UBT) were enrolled from March 2012 to March 2017. Intracranial atherosclerosis was further measured using intracranial carotid artery calcification (ICAC) on past or recent head CT, and 14,084 subjects were ultimately included in the study. Baseline demographics, atherosclerosis risk factors, and laboratory results were investigated. Since endothelial dysfunction is critical to the development of atherosclerosis, the role of H. pylori in migration, tube formation, and proliferation of human brain microvascular endothelial cells (HBMECs) was assessed in vitro.

Results: The intracranial atherosclerosis group had a higher proportion of women and a greater rate of H. pylori infection than those without intracranial atherosclerosis. H. pylori infection was significantly more common in women with intracranial atherosclerosis than males. In addition, the incidence of intracranial atherosclerosis was significantly higher in women with H. pylori infection than uninfected women (53.8 vs. 46.4%, p &lt; 0.001). In an adjusted model, H. pylori was shown to be an independent risk factor for intracranial atherosclerosis in women ≤ 60 years of age [odds ratio (OR) = 2.261, 95% CI = 1.839–2.780, p &lt; 0.001]. Serum exosomes from patients with H. pylori infection had significantly reduced brain endothelial cell migration, tube formation, and proliferation in vitro.

Conclusion:Helicobacter pylori infection may be an important independent risk factor for intracranial atherosclerosis in women ≤ 60 years of age.

Association of Helicobacter pylori infection with the risk of metabolic syndrome and insulin resistance: an updated systematic review and meta-analysis

BACKGROUND

Conflicting results of recent studies on the association between Helicobacter pylori (H. pylori) infection and the risk of insulin resistance and metabolic syndrome explored the need for updated meta-analysis on this issue. Therefore, this systematic review aimed to estimate the pooled effect of H. pylori infection on the risk of insulin resistance and metabolic syndrome.

METHODS

To identify case-control studies and cohort studies evaluating the association of H. pylori infection with insulin resistance and metabolic syndrome, a comprehensive literature search was performed from international databases including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL from January 1990 until January 2021. We used odds ratio with its 95% confidence interval to quantify the effect of case-control studies and risk ratio with its 95% CI for the effect of cohort studies.

RESULTS

22 studies with 206,911 participants were included for meta-analysis. The pooled estimate of odds ratio between H. pylori infection and metabolic syndrome in case-control studies was 1.19 (95% CI 1.05-1.35; I2 = 0%), and in cohort studies, the pooled risk ratio was 1.31 (95% CI 1.13-1.51; I2 = 0%). Besides, case-control studies showed the pooled odds ratio of 1.54 (95% CI 1.19-1.98; I2 = 6.88%) for the association between H. pylori infection and insulin resistance.

CONCLUSION

In this meta-analysis, the results showed that there was a possibility of metabolic syndrome and insulin resistance in case of H. pylori infection.

Helicobacter pylori infection worsens impaired glucose regulation in high-fat diet mice in association with an altered gut microbiome and metabolome

Emerging evidence suggests that Helicobacter pylori infection is associated with metabolic disorders, although the underlying mechanisms are poorly defined. This study aimed to investigate the interaction among H. pylori, a high-fat diet (HFD), and the gut microbiota with glucose regulation and alterations in microbial metabolites. Mice were randomly allocated to H. pylori-infected and noninfected groups fed a chow diet or an HFD. After 4 weeks, two of the HFD groups were given antibiotic cocktails for 8 weeks to eliminate the gut microbiota. The results showed that an HFD significantly promoted increases in body weight, insulin resistance, and glucose intolerance, which were alleviated to normal after antibiotic treatment. H. pylori infection aggravated HFD-induced hyperglycemia, which could not be restored by antibiotics. The perturbation of the gut microbiota was greater in the mice cotreated with H. pylori and an HFD (HFDHp) compared to those administered either H. pylori or an HFD alone, with a loss of diversity, higher abundance of Helicobacter, and lower abundance of Lactobacillus. Furthermore, compared to that of the HFD alone group, the gut microbiota of the HFDHp group was much more susceptible to antibiotic destruction, with extremely lower diversity and dominance of Klebsiella. Fecal metabolome analyses demonstrated that the combination of H. pylori infection and an HFD altered metabolic composition and function, which were linked to glucose dysregulation. H. pylori infection may exacerbate the dysbiosis of the gut microenvironment induced by an HFD, including alterations in the microbiota and metabolites, which weakens the restorative effect of antibiotics and results in the persistence of glucose disorders. KEY POINTS: • The interplay of Hp, HFD, and antibiotics on glucose metabolism was firstly explored. • Hp infection impaired the effect of antibiotics on HFD-induced glucose dysregulation. • Hp infection altered gut microbiota and metabolites which aggravated by HFD.

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

Osteoporosis (OP) and osteoporotic fractures (OFs) are common multifactorial and heterogenic disorders of increasing incidence. Helicobacter pylori (H.p.) colonizes the stomach approximately in half of the world's population, causes gastroduodenal diseases and is prevalent in numerous extra-digestive diseases known to be associated with OP/OF. The studies regarding relationship between H.p. infection (HPI) and OP/OFs are inconsistent. The current review summarizes the relevant literature on the potential role of HPI in OP, falls and OFs and highlights the reasons for controversies in the publications. In the first section, after a brief overview of HPI biological features, we analyze the studies evaluating the association of HPI and bone status. The second part includes data on the prevalence of OP/OFs in HPI-induced gastroduodenal diseases (peptic ulcer, chronic/atrophic gastritis and cancer) and the effects of acid-suppressive drugs. In the next section, we discuss the possible contribution of HPI-associated extra-digestive diseases and medications to OP/OF, focusing on conditions affecting both bone homeostasis and predisposing to falls. In the last section, we describe clinical implications of accumulated data on HPI as a co-factor of OP/OF and present a feasible five-step algorithm for OP/OF risk assessment and management in regard to HPI, emphasizing the importance of an integrative (but differentiated) holistic approach. Increased awareness about the consequences of HPI linked to OP/OF can aid early detection and management. Further research on the HPI-OP/OF relationship is needed to close current knowledge gaps and improve clinical management of both OP/OF and HPI-related disorders.

The impact of Helicobacter pylori infection on gut microbiota-endocrine system axis; modulation of metabolic hormone levels and energy homeostasis

The gut microbiota is a complex ecosystem that is involved in the development and preservation of the immune system, energy homeostasis and nutritional status of the host. The crosstalk between gut microbiota and the host cells modulates host physiology and metabolism through different mechanisms. Helicobacter pylori (H. pylori) is known to reside in the gastric mucosa, induce inflammation, and alter both gastric and intestinal microbiota resulting in a broad spectrum of diseases, in particular metabolic syndrome-related disorders. Infection with H. pylori have been shown to affect production level and physiological regulation of the gut metabolic hormones such as ghrelin and leptin which are involved in food intake, energy expenditure and body mass. In this study, we reviewed and discussed data from the literature and follow-up investigations that links H. pylori infection to alterations of the gut microbiota and metabolic hormone levels, which can exert broad influences on host metabolism, energy homeostasis, behavior, appetite, growth, reproduction and immunity. Also, we discussed the strong potential of fecal microbiota transplantation (FMT) as an innovative and promising investigational treatment option for homeostasis of metabolic hormone levels to overcome H. pylori-associated metabolic syndrome-related disorders.

Helicobacter pylori infection increases the risk of metabolic syndrome in pregnancy: a cohort study

Background

The effects of Helicobacter pylori (H. pylori) infection on metabolic syndrome (MetS) in pregnant women are unclear to date. This study was designed to explore the relationship between H. pylori infection and MetS during pregnancy.

Methods

Pregnant women were enrolled in the prospective cohort study, and their demographic data and metabolic parameters were collected. H. pylori infection was measured using the C13 urea breath test. All enrolled patients were followed up until the last baby was born. Metabolic disorders, including elevated levels of serum triglycerides (TG), high-density lipoprotein (HDL) cholesterol and blood glucose (BG), and adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, spontaneous preterm birth (SPB), fetal growth restriction (FGR), and uncomplicated pregnancy, were recorded during follow up.

Results

There were 320 pregnant women enrolled in this study. They were divided into two groups according to H. pylori infection, and each group was then divided into two subgroups on whether their BMI was more than 24 or not. The results showed that H. pylori infection significantly increased the incidence of MetS as well as other metabolic disorders, especially in pregnant women with high BMI. Multivariable logistic regression analysis showed that risk factors of MetS were high BMI and H. pylori infection. Besides, H. pylori infection increased the incidence of GDM and preeclampsia and potentially reduced the incidence of uncomplicated pregnancy.

Conclusions

H. pylori infection in pregnant women acts as a crucial risk factor of Mets and affects the incidence of several adverse pregnancy outcomes.

The association between Helicobacter pylori infection with overweight/obesity: A protocol for a systematic review and meta-analysis of observational studies

BACKGROUND

Obesity has become a serious public health issue. The role of Helicobacter pylori (H. pylori) infection in overweight or obesity is inconsistent and controversial. It is very necessary to conduct a systematic review and meta-analysis for determining whether H. pylori infection was associated with risk of overweight/obesity.

METHODS

Four databases (PubMed, Web of Science, The Cochrane Library, and EMBASE) will be searched from the inception to January 15, 2019. All observational studies (including cross-sectional, case-control or longitudinal studies) reporting the association between H. pylori infection and overweight/obesity will be included. The primary outcome was the presence and incidence of overweight/obesity in conjunction with H. pylori infection. Study selection, data extraction, and assessment of quality will be conducted independently by 2 reviewers. RevMan 5.3 and STATA 14.0 software will be used for data synthesis.

RESULTS

The results of this study will provide a better understanding of the role of H. pylori infection in overweight/obesity among overall population.

CONCLUSION

This systematic review and meta-analysis will generate evidence of the association between H. pylori infection and overweight/obesity, and the findings of this study will be published in a peer-reviewed journal.PROSPERO registration number: CRD42019121939.