Korean J Fam Med.  2015 Sep;36(5):227-232. 10.4082/kjfm.2015.36.5.227.

Association between Helicobacter pylori Infection and Cerebral Small Vessel Disease

Affiliations
  • 1Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea. jie2128@gmail.com
  • 2Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

Abstract

BACKGROUND
Small vessel disease is an important cause of cerebrovascular diseases and cognitive impairment in the elderly. There have been conflicting results regarding the relationship between Helicobacter pylori infection and ischemic stroke. This study aimed to examine the association between H. pylori infection and cerebral small vessel disease.
METHODS
The study included 1,117 patients who underwent brain magnetic resonance imaging and H. pylori identification between 2005 and 2013 at Health Promotion Center, Seoul National University Hospital. Multivariable logistic regression analysis was used to assess the association between H. pylori infection and small vessel disease with adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, smoking status, problem drinking, and antiplatelet use.
RESULTS
The adjusted odds ratios (aORs) for the association between H. pylori infection and silent brain infarction and cerebral microbleeds were 1.03 (95% confidence interval [CI], 0.66-1.61) and 0.70 (95% CI, 0.38-1.28), respectively. The aORs for silent brain infarction and cerebral microbleeds were 0.81 (95% CI, 0.44-1.44) and 0.59 (95% CI, 0.30-1.18) in patients aged <65 years and 1.59 (95% CI, 0.78-3.22) and 1.89 (95% CI, 0.38-9.33) in those aged >65 years, respectively. Moreover, the aORs for silent brain infarction and cerebral microbleeds were 0.96 (95% CI, 0.54-1.71) and 0.74 (95% CI, 0.33-1.69) in H. pylori-infected patients without atrophic gastritis and 0.89 (95% CI, 0.48-1.62) and 0.99 (95% CI, 0.43-2.27) in those with atrophic gastritis, respectively.
CONCLUSION
No association between H. pylori infection and small vessel disease was observed. H. pylori-induced inflammation may not be a risk factor for microcirculatory damage in the brain.

Keyword

Helicobacter pylori; Small Vessel Disease; Silent Brain Infarction; Cerebral Microbleeds

MeSH Terms

Aged
Body Mass Index
Brain
Brain Infarction
Cerebral Small Vessel Diseases*
Diabetes Mellitus
Drinking
Dyslipidemias
Gastritis, Atrophic
Health Promotion
Helicobacter pylori*
Helicobacter*
Humans
Hypertension
Inflammation
Logistic Models
Magnetic Resonance Imaging
Odds Ratio
Risk Factors
Seoul
Smoke
Smoking
Stroke
Smoke
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