Quadri R, Rossi C, Catalfamo E, Masoero G, Lombardo L, Della Monica P, Rovera L, Pera A, Cavello Perin P
Divisione Universitaria di Medicina Interna, Ospedale San Vito, Turin, Italy.
Nutr Metab Cardiovasc Dis. 2000 Oct;10(5):263-6.
A high prevalence of Helicobacter pylori (Hp) infection in diabetic patients has been described in recent years. This study investigates its prevalence in type 2 diabetics and its correlation with the degree of metabolic control and the presence of chronic complications.
Forty-one consecutive type 2 diabetics (21 males, 20 females aged 46-78, mean 62) and 31 age-matched controls participated. Hp infection was assessed by means of the 13C-urea breath test. Fasting glucose and glycated haemoglobin (HbA1c) levels were measured to evaluate metabolic control. Chronic complications were assessed by means of albumin excretion rate (AER), fundoscopy, vibratory perception threshold (VPT), ECG, clinical history of coronary, cerebral or peripheral arteriopathy, foot examination and cardiovascular autonomic function tests. A higher prevalence of Hp infection was found in diabetic than in control women (80% vs 37.5%; p < 0.05), whereas there was no difference between males. A higher prevalence correlated with macroangiopathy and neuropathy and higher BMI, blood pressure, fasting glucose and HbA1c values. By contrast, microangiopathy was significantly more prevalent (p < 0.05) in Hp negative (85%) than in Hp positive patients (48%).
There is a high prevalence of Hp infection in type 2 diabetic women. The absence of microangiopathy may be a predisposing factor: microvascular changes in the gastric mucosa may create an unfavourable environment for the establishment or survival of Hp.
近年来，已有研究报道糖尿病患者中幽门螺杆菌（Hp）感染率较高。本研究调查了2型糖尿病患者中Hp的感染率及其与代谢控制程度和慢性并发症的相关性。
连续纳入41例2型糖尿病患者（男21例，女20例，年龄46 - 78岁，平均62岁）和31例年龄匹配的对照者。采用¹³C - 尿素呼气试验评估Hp感染情况。测量空腹血糖和糖化血红蛋白（HbA1c）水平以评估代谢控制情况。通过白蛋白排泄率（AER）、眼底检查、振动觉阈值（VPT）、心电图、冠状动脉、脑血管或外周动脉病变的临床病史、足部检查和心血管自主神经功能测试来评估慢性并发症。发现糖尿病女性患者中Hp感染率高于对照女性（80%对37.5%；p < 0.05），而男性之间无差异。较高的感染率与大血管病变、神经病变以及较高的体重指数、血压、空腹血糖和HbA1c值相关。相比之下，Hp阴性患者的微血管病变明显更常见（p < 0.05）（85%），高于Hp阳性患者（48%）。
2型糖尿病女性中Hp感染率较高。无微血管病变可能是一个易感因素：胃黏膜的微血管变化可能为Hp的定植或存活创造不利环境。
