Effects of Helicobacter pylori infection on the components of metabolic syndrome. Review

Abstract

The article emphasizes the ability of Helicobacter pylori (H. pylori) to influence metabolic processes and considers possible mechanisms of such influence. The data presented that H. pylori infection increases the frequency of metabolic syndrome and its components. It is emphasized that systemic chronic inflammatory processes (one of the main links in the pathogenesis of metabolic‑associated diseases) can be initiated by H. pylori due to the activation of «classical» mechanisms inherent in metabolic diseases: activation of pro‑inflammatory cytokines (tumor necrosis factor‑α, interleukins‑1, ‑6,) and adipocyte hormones. This is primarily due to the ability of H. pylori to produce cytotoxins (Cag/Vac A) and the presence of lipopolysaccharide in its own cell wall (endotoxin), which can both directly and indirectly induce a pro‑inflammatory response, including a systemic one. In support of this, the data showing that H. pylori eradication prevents repeated stenosis of the coronary arteries after stent placement, leads to an improvement in the course of arterial hypertension, and a significant decrease in the levels of C‑reactive protein. In addition, the effect of H. pylori on pro‑inflammatory cytokines and adipocyte hormones can contribute to the formation of an abnormal proatherogenic lipid profile. This is confirmed by data on the decrease in the levels of total cholesterol, triglycerides, low‑density lipoprotein cholesterol against the background of an increase in the concentration of high‑density lipoprotein cholesterol after successful eradication of H pylori. Also noted that H. pylori infection is a potential contributing factor to insulin resistance and chronic hyperglycemia, and this is also largely related to the ability of Helicobacter pylori to produce cytotoxins. Some investigators haven’t established the relationship between H. pylori and glycosylated hemoglobin levels, that can be explained by the use of serological methods for H. pylori diagnosis. The differences in research results may be associated with methodological errors, therefore, further research is needed in this direction, which will contribute to the development of preventive and therapeutic strategies.