1型糖尿病年轻患者的幽门螺杆菌感染及根除与糖化血红蛋白水平（HbA1c）无关

[Helicobacter pylori infection and eradication are not related to glycosylated hemoglobin levels (HbA1c) in young patients with type 1 diabetes].

作者信息

Khalil Toufiq, Dorchy Harry, Scaillon Michèle, Melot Christian

机构信息

Clinique de diabétologie, Hôpital universitaire des enfants reine Fabiola, Bruxelles, Belgique.

出版信息

Presse Med. 2007 Sep;36(9 Pt 1):1191-5. doi: 10.1016/j.lpm.2006.12.030. Epub 2007 Mar 13.

DOI:10.1016/j.lpm.2006.12.030

PMID:17360147

Abstract

OBJECTIVE

Helicobacter pylori (Hp) is a chronic stomach infection common throughout the world. The pediatric diabetes literature on the relation between Hp and HbA1c is sparse and controversial. This study aimed to investigate this relation.

METHODS

The study included 100 youth with type 1 diabetes and seropositive for Hp (European Caucasians: n=49; Moghrabin Caucasians: n=51). Mean socioeconomic status was lower among the latter. Hp infection was demonstrated by the (13)C-urea breath test and a gastric biopsy for antibiotic susceptibility testing. HbA1c levels were measured for a year (mean: 6 measurements; upper normal limit: 6.2%) before and after Hp eradication, which was proved by the (13)C-urea breath test.

RESULTS

Of 100 Hp-seropositive patients, 49 had active Hp infections and were treated. Mean age+/-SD was 14.2+/-2.8 years, and duration of diabetes at Hp diagnosis was 6.2 +/-2.3 years. Hp infection was eradicated in 38/49 subjects (78%). Eleven (22%) remained infected and required a second treatment. The two subgroups did not differ for age, duration of diabetes or pretreatment HbA1c levels (7.3+/-1.5% versus 7.8+/-0.8%; p=0.16). Mean HbA1c levels in the 49 infected subjects did not differ significantly in the year before and after eradication (7.4+/-1.3% versus 7.9+/-1.1%; p=0.08). Prevalence of infection was higher among youth of North African than European ancestry (47% versus 22%; p<0.001). Their HbA1c levels, however, did not differ (7.3+/-1.5% versus 7.7+/-0.9%; p=0.31), nor did age or duration of diabetes. Among the 100 Hp-seropositive patients, vague abdominal pain was reported by 45 of them; only 24 had active Hp infections.

CONCLUSION

Before treatment, patients seropositive for Hp did not differ in HbA1c levels or abdominal complaints according to whether they had active Hp infection. Hp infection was twice as frequent in Moghrabin Caucasians than in European Caucasians, perhaps associated with their lower socioeconomic status. HbA1c levels were similar in patients with and without Hp eradication after one treatment. After a one-year follow-up, Hp eradication had no significant effect on HbA1c levels.

摘要

目的

幽门螺杆菌（Hp）是一种在全球普遍存在的慢性胃部感染菌。儿科糖尿病文献中关于Hp与糖化血红蛋白（HbA1c）之间关系的研究较少且存在争议。本研究旨在调查这种关系。

方法

该研究纳入了100名1型糖尿病且Hp血清学阳性的青少年（欧洲白种人：n = 49；摩洛哥白种人：n = 51）。后者平均社会经济地位较低。通过（13）C - 尿素呼气试验及胃活检进行抗生素敏感性检测来证实Hp感染。在通过（13）C - 尿素呼气试验证实Hp根除前后，对HbA1c水平进行为期一年的测量（平均：6次测量；正常上限：6.2%）。

结果

100名Hp血清学阳性患者中，49例有活动性Hp感染并接受了治疗。平均年龄±标准差为14.2±2.8岁，诊断Hp时糖尿病病程为6.2±2.3年。49名受试者中有38名（78%）的Hp感染被根除。11名（22%）仍有感染，需要进行二次治疗。这两个亚组在年龄、糖尿病病程或治疗前HbA1c水平方面无差异（7.3±1.5%对7.8±0.8%；p = 0.16）。49名感染患者在根除前后一年的平均HbA1c水平无显著差异（7.4±1.3%对7.9±1.1%；p = 0.08）。北非血统青少年的感染率高于欧洲血统青少年（47%对22%；p < 0.001）。然而，他们的HbA1c水平无差异（7.3±1.5%对7.7±- 0.9%；p = 0.31），年龄和糖尿病病程也无差异。在100名Hp血清学阳性患者中，45人报告有模糊腹痛；只有24人有活动性Hp感染。