Xia H H, Talley N J, Kam E P, Young L J, Hammer J, Horowitz M
Department of Medicine, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
Am J Gastroenterol. 2001 Apr;96(4):1039-46. doi: 10.1111/j.1572-0241.2001.03604.x.
The association between Helicobacter pylori (H. pylori) infection and diabetes mellitus is controversial. We aimed to determine the prevalence of H. pylori infection in patients with diabetes and nondiabetic controls, and assess whether H. pylori infection was associated with upper gastrointestinal (GI) symptoms in diabetes mellitus.
A total of 429 patients with type 1 (n = 49) or type 2 (n = 380) diabetes mellitus (48.6% women, mean age 60.7 yr) and 170 nondiabetic controls (34.7% women, mean age 60.4 yr) were evaluated. All subjects completed a validated questionnaire (the Diabetes Bowel Symptom Questionnaire) to determine upper GI symptoms, and a blood sample was tested for H. pylori infection using a validated ELISA kit (sensitivity 96%, specificity 94%).
Seroprevalence of H. pylori was 33% and 32%, respectively, in patients with diabetes and controls (NS). In both groups, the seroprevalence was significantly higher in men than in women; 39% vs 25% (p = 0.002) in diabetic patients, and 40% vs 20% (p = 0.01) in controls. Patients with diabetes had a significantly higher prevalence of early satiety (OR = 2.30), fullness (OR = 3.15), and bloating (OR = 1.50) compared with controls. Upper GI symptoms were present in 49% of H. pylori-positive and 53% of H. pylori-negative patients with diabetes (OR = 0.87, 95% CI 0.58-1.31, p = 0.56). H. pylori infection was also not associated with any of the individual upper GI symptoms before or after adjustment for potential confounding factors. However, patient age and female gender were identified as independent risk factors for upper GI symptoms. Smoking was a risk factor for bloating and early satiety.
H. pylori infection appears not to be associated with diabetes mellitus or upper GI symptoms in diabetes mellitus.
幽门螺杆菌（H. pylori）感染与糖尿病之间的关联存在争议。我们旨在确定糖尿病患者和非糖尿病对照人群中幽门螺杆菌感染的患病率，并评估幽门螺杆菌感染是否与糖尿病患者的上消化道（GI）症状相关。
对总共429例1型（n = 49）或2型（n = 380）糖尿病患者（女性占48.6%，平均年龄60.7岁）和170例非糖尿病对照者（女性占34.7%，平均年龄60.4岁）进行评估。所有受试者均完成一份经过验证的问卷（糖尿病肠道症状问卷）以确定上消化道症状，并使用经过验证的ELISA试剂盒（灵敏度96%，特异性94%）检测血样中的幽门螺杆菌感染情况。
糖尿病患者和对照人群中幽门螺杆菌的血清阳性率分别为33%和32%（无显著差异）。两组中，男性的血清阳性率均显著高于女性；糖尿病患者中为39%对25%（p = 0.002），对照人群中为40%对20%（p = 0.01）。与对照者相比，糖尿病患者早饱（比值比[OR]=2.30）、饱腹感（OR = 3.15）和腹胀（OR = 1.50）的患病率显著更高。49%的幽门螺杆菌阳性糖尿病患者和53%的幽门螺杆菌阴性糖尿病患者存在上消化道症状（OR = 0.87，95%置信区间0.58 - 1.31，p = 0.56）。在对潜在混杂因素进行调整前后，幽门螺杆菌感染也与任何个体上消化道症状均无关联。然而，患者年龄和女性性别被确定为上消化道症状的独立危险因素。吸烟是腹胀和早饱的危险因素。
幽门螺杆菌感染似乎与糖尿病或糖尿病患者的上消化道症状无关。
