Abstract

Emerging studies have shed light on the association between Helicobacter pylori (HP) infection and cardiometabolic risk. However, there is no evidence to support a causal link for the relationship in the general population. Our aim was to determine whether HP infection is associated with the risks of incident type II diabetes mellitus (DM) in a population-based cohort consisting of adults from the general population. A total of 69235 adults enrolled in the study obtained health examinations at the Tri-Service General Hospital in Taiwan from 2010 to 2016. HP infection detection was performed by rapid urease tests (RUTs), and endoscopic examinations were used to diagnose gastroesophageal reflux disease (GERD), gastric ulcers (GUs) and duodenal ulcers (DUs). Cross-sectional and longitudinal analyses were performed to examine the association between HP infection and cardiometabolic diseases using logistic regression and Cox regression in a large population-based study. HP infection was significantly associated with the presence of metabolic syndrome (MetS) (OR = 1.26, 95%CI: 1.00–1.57) and DM (OR = 1.59, 95%CI: 1.17–2.17) only in male subjects, and abnormal endoscopic findings were also correlated with cardiometabolic diseases. Our findings demonstrated that participants with HP infection had an elevated risk of developing incident DM (HR = 1.54, 95%CI: 1.11–2.13). In addition, endoscopic findings of a DU (HR = 1.63, 95%CI: 1.02–2.63), rather than GERD or a GU, were also predictive of incident DM. In this cohort, HP infection was a statistically significant predictor of incident DM among male population.

Highlights

  • Helicobacter pylori (HP) is a common worldwide infection in developing countries and results in gastrointestinal complications such as peptic ulcer and gastric cancer[1]

  • Our aim was to determine whether HP infection is associated with the risks of incident diabetes mellitus (DM) in a population-based cohort consisting of adults from the general population

  • After fully adjusting for covariables, HP infection had a positive association with metabolic syndrome (MetS) and DM in males with odds ratios (ORs) of 1.25 and 1.53 (95%CI = 1.15–2.04), respectively

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Summary

Introduction

Helicobacter pylori (HP) is a common worldwide infection in developing countries and results in gastrointestinal complications such as peptic ulcer and gastric cancer[1]. Prevalent extra-gastroduodenal diseases have been reported in those with HP infection including coronary heart disease[4], hepatobiliary diseases [5], and autoimmune disorders[6]. The pathophysiology of DM is complicated, with risk factors correlated to lifestyle and genetic background[7]. Simon et al first suggested the link between HP infection and DM[8], and the role of HP in the development of DM has since become better understood. Considerable evidence indicates that the pathogenic mechanisms for DM such as inflammation and insulin resistance are induced by HP infection[9]

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