No association between Helicobacter pylori infection and diabetes mellitus among a general Japanese population: a cross-sectional study.

Takashi Tamura,Tae Sasakabe,Shino Suma,Nana Fukuda,Mariko Naito,Kenji Wakai,Sayo Kawai,Rieko Okada,Asahi Hishida,Hiroko Nakagawa,Yuka Sugimoto,Nobuyuki Hamajima,Emi Morita

doi:10.1186/s40064-015-1371-2

Abstract

Several case-control studies have reported that patients with diabetes mellitus (DM) had a higher prevalence of Helicobacter pylori infection than those without DM, but these findings remain equivocal. Additionally, there are few studies examining associations between East Asian CagA-positive H. pylori and DM. This cross-sectional study aimed to investigate whether H. pylori infection was a possible risk factor for DM in a general Japanese population. The study included 5165 subjects (1467 men, 3698 women) aged 35–69 years from the Daiko Study, part of the Japan Multi-Institutional Collaborative Cohort Study. A urinary anti-H. pylori antibody was used to detect H. pylori infection. The medical history of physician-diagnosed DM was confirmed by self-administered questionnaire. The odds ratios (ORs) and their 95 % confidence intervals (CIs) for DM (current and former) were calculated using unconditional logistic regression analysis, adjusting for age, sex, educational status, alcohol use, smoking status, body mass index, energy intake, and physical activity. The prevalence of DM was 4.6 % (95 % CI 3.7–5.6 %) among 1878 participants with H. pylori infection and 3.2 % (2.6–3.8 %) among 3287 without the infection (p = 0.009). The crude, age-adjusted, and multivariate-adjusted ORs for DM in those with the infection relative to those without were 1.47 (95 % CI 1.10–1.97), 1.02 (0.76–1.38), and 0.97 (0.71–1.32), respectively. We found a significantly higher DM prevalence among those with H. pylori infection than among those without. However, almost all the difference in prevalence could be explained by the older age of those infected. Our findings did not support an association between H. pylori infection and DM.

Highlights

Helicobacter pylori infection is a major risk factor for gastric cancer (Montecucco and Rappuoli 2001) and is well known as a causative factor for ulcers, atrophic gastritis, mucosa-associated lymphoid tissue lymphoma, and intestinal metaplasia (Labenz and Borsch 1994; Asaka et al 2001; Wundisch et al 2005)
Several cross-sectional studies showed that H. pylori infection was associated with diabetes mellitus
We aimed to investigate whether or not H. pylori infection was associated with diabetes mellitus (DM) in a cross-sectional study in the same population

Summary

Introduction

Helicobacter pylori infection is a major risk factor for gastric cancer (Montecucco and Rappuoli 2001) and is well known as a causative factor for ulcers, atrophic gastritis, mucosa-associated lymphoid tissue lymphoma, and intestinal metaplasia (Labenz and Borsch 1994; Asaka et al 2001; Wundisch et al 2005). Helicobacter pylori infection has been estimated to be present in half of the world’s population, and it has been reported to be higher. Helicobacter pylori infection has been linked with the activation of toll-like receptors, resulting in energy harvesting and fat accumulation, which lead to insulin resistance (Manco et al 2010). Several cross-sectional studies showed that H. pylori infection was associated with diabetes mellitus. The association between H. pylori infection and the risk of DM remains controversial, because several cross-sectional studies reported that H. pylori was not associated with insulin resistance or the prevalence of DM (Ko et al 2001; Anastasios et al 2002; Howard et al 2008; Lutsey et al 2009), and there are few studies reporting such associations among large populations in East Asia, where the more pathogenic East Asian CagA-positive strain of H. pylori is dominant (Fock and Ang 2010)

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