Abstract
BackgroundHelicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders. Our aim is to investigate the association between H. pylori infection and bone mineral density.MethodsThis retrospective cross-sectional study was performed by using the data from the health examination database in a medical center of southern Taiwan in 2013. We investigated the relationship between sex, age, body mass index (BMI), waist circumstance, lipid profile, H. pylori infection, the findings of upper gastrointestinal endoscopy and bone mineral density (BMD). Because of nonrandomized assignment and strong confounding effect of age on BMD, the 1:1 propensity score match was applied for age adjustment. The simple and multiple stepwise logistic regression analysis were performed to assess the risk factors of decreased BMD in these well-balanced pairs of participants.ResultsOf the 867 subjects in final analysis with the mean age of 55.9 ± 11.3 years, 381 (43.9%) subjects had H. pylori infection, and 556 (64.1%) subjects had decreased BMD. In decreased BMD group, the portion of woman was higher than a normal BMD group (37.2% versus 29.6%, P = 0.023), the age was significantly older (59.4 ± 9.8 versus 49.8 ± 11.3, p < 0.001) and BMI was significantly lower (24.7 ± 3.5 versus 25.4 ± 3.7, p = 0.006) than the normal BMD group. The prevalence of H. pylori infection was 39.9% and 46.2% in the normal BMD group and the decreased BMD group respectively (P = 0.071). The multivariate analysis which was used for these possible risk factors showed that only advanced age (OR 1.09, 95% CI 1.08–1.11, P < 0.001), and low BMI (OR 0.91, 95% CI 0.87–0.95, P < 0.001) were independently significantly associated with decreased BMD in this nonrandomized study. In the propensity score-matched participants, the multiple stepwise logistic regression analysis revealed H. pylori infection (OR 1.62, 95% CI 1.12–2.35, P = 0.011) and low BMI (OR 0.92, 95% CI 0.87–0.97, P = 0.001) were independently significantly associated with decreased BMD.ConclusionsH. pylori infection and low BMI were independently significantly associated with decreased BMD in selected propensity score-matched populations after age adjustment.
Highlights
Helicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders
Prevalence of H. pylori infection and decreased BMD We enroll 942 subjects who participated in the health examination and underwent biochemistry blood examination, upper gastrointestinal endoscopy with CLO test and the bone mineral density examinations
Simple logistic regression (Table 3) showed decreased BMD was significantly associated with the female gender, advanced age, low body mass index (BMI), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and peptic ulcer disease
Summary
Helicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders. Our aim is to investigate the association between H. pylori infection and bone mineral density. Osteoporosis is a silent health problem characterized by decreased bone mineral density (BMD) with a risk of spine and hip fractures. Half of the hip fractures globally result from osteoporosis. According to data from the National Health Insurance Research Database between 1996 and 2010 in Taiwan, the high annual incidence rate of hip fracture was 472.1 per 100,000 patients per year, higher than that in other Asian countries and even in the world. The spine and hip fractures resulted from osteoporosis could induce patients to become bedridden and needing care. Mortality and disability-associated osteoporosis have significant impact on prognosis and are a burden affecting patients, their families, society, and the health system. Identification of the risk of decreased BMD and osteoporosis is very important. Several gastrointestinal diseases such as inflammatory bowel disease, peptic ulcer disease and atrophic gastritis have been suspected of being risk factors for osteoporosis [4,5,6]
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