Endocrinol Metab.  2015 Sep;30(3):280-287. 10.3803/EnM.2015.30.3.280.

Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients

• Bahadoran
• Mirmiran P
• Zarif-yeaganeh M
• Zojaji H
• Azizi F

• KMID: 2407078
• DOI: http://doi.org/10.3803/EnM.2015.30.3.280

Abstract

BACKGROUND
Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients.
METHODS
In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index.
RESULTS
The mean age of participants was 54+/-10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24+/-0.23 microg/mL and 9.9+/-9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (beta=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; beta=0.43, P<0.01), and triglycerides/HDL-C ratio (beta=-0.28, P<0.05) were observed.
CONCLUSION
Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.

Keyword

Helicobacter pylori infection; Diabetes mellitus, type 2; Pepsinogens; Gastric inflammation; Cardiometabolic risk factors

MeSH Terms

Bacterial Load
Biomarkers*
Blood Glucose
Blood Pressure
Body Weight
C-Reactive Protein
Cardiovascular Diseases
Cholesterol, HDL
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Fasting
Helicobacter pylori*
Helicobacter*
Humans
Inflammation*
Insulin
Insulin Resistance
Lipid Accumulation Product
Lipoproteins
Male
Malondialdehyde
Pepsinogen A
Pepsinogen C
Pepsinogens
Risk Factors*
Triglycerides
Waist Circumference
C-Reactive Protein
Cholesterol, HDL
Insulin
Lipoproteins
Malondialdehyde
Pepsinogen A
Pepsinogen C
Pepsinogens
Triglycerides

Figure

• 

  Fig. 1 Linear or logarithmic association of pepsinogen I to pepsinogen II ratio and cardiometabolic risk factors (regression curve estimation models were used). (A) A significant linear association of pepsinogen I (PGI)/pepsinogen II (PGII) ratio with serum triglycerides (β=-0.24, P<0.05). (B) A significant linear association of PGI/PGII ratio with serum high density lipoprotein cholesterol (HDL-C; β=0.43, P<0.01). (C) A significant linear association of PGI/PGII ratio triglycerides/HDL-C ratio (β=-0.28, P<0.05). (D) A significant logarithmic association between the PGI/PGII ratio and lipid accumulation product (β=-0.31, P<0.05). (E) A significant logarithmic association between the PGI/PGII ratio and waist circumference (β=-0.30, P<0.05). (F) A significant logarithmic association between the PGI/PGII ratio and body weight (β=-0.26, P<0.05).

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