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有消化不良症状的糖尿病患者中幽门螺杆菌的患病率及其与血糖控制和晚期并发症的关系。

Helicobacter pylori prevalence in diabetes mellitus patients with dyspeptic symptoms and its relationship to glycemic control and late complications.

作者信息

Demir Mehmet, Gokturk Huseyin Savas, Ozturk Nevin Akcaer, Kulaksizoglu Mustafa, Serin Ender, Yilmaz Ugur

机构信息

Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey.

出版信息

Dig Dis Sci. 2008 Oct;53(10):2646-9. doi: 10.1007/s10620-007-0185-7. Epub 2008 Mar 5.

Abstract

BACKGROUND

There are contradictory reports on Helicobacter pylori prevalence and its relationship to late complications of diabetes mellitus (DM). The aim of this study was to determine the prevalence of H. pylori infection in type 2 DM patients and to evaluate the relationship between H. pylori infection and the glycemic control, late complications.

MATERIAL AND METHOD

A total of 141 type 2 DM patients and 142 nondiabetic subjects with upper gastrointestinal symptoms were enrolled in the study. All patients underwent upper gastrointestinal endoscopy with biopsy specimens obtained from gastric antrum and corpus. H. pylori status was evaluated in each patient by both the rapid urease test and histopathological examination. Plasma glucose, HbA1c, microalbuminuria in 24 h collected urine, electroneuromyography, and fundoscopic examinations were performed in all subjects.

RESULTS

The prevalence of H. pylori infection was 61.7% and 58.5%, respectively, among type 2 diabetic patients and nondiabetic controls and was not statistically significant (P = 0.577). The duration of diabetes, fasting blood glucose and haemoglobin A1c levels, nephropathy and retinopathy prevalence did not differ significantly between the two groups (diabetics versus nondiabetics). There was no late complication in 60.3% of the type 2 diabetic patients as compared to at least one late complication in the remainders. A statistically significant correlation was found between H. pylori infection and the presence of neuropathy (P = 0.021).

CONCLUSIONS

The prevalence of H. pylori infection did not differ significantly between the diabetic patients and nondiabetic controls. Interestingly, diabetics with H. pylori infection had a higher incidence of neuropathy, although there was no association between the duration and regulation of diabetes, retinopathy, nephropathy and H. pylori status.

摘要

背景

关于幽门螺杆菌的患病率及其与糖尿病(DM)晚期并发症的关系,存在相互矛盾的报道。本研究的目的是确定2型糖尿病患者中幽门螺杆菌感染的患病率,并评估幽门螺杆菌感染与血糖控制、晚期并发症之间的关系。

材料与方法

共有141例有上消化道症状的2型糖尿病患者和142例非糖尿病受试者纳入本研究。所有患者均接受上消化道内镜检查,并从胃窦和胃体获取活检标本。通过快速尿素酶试验和组织病理学检查评估每位患者的幽门螺杆菌感染状况。对所有受试者进行血浆葡萄糖、糖化血红蛋白、24小时尿微量白蛋白、神经电生理检查和眼底检查。

结果

2型糖尿病患者和非糖尿病对照组中幽门螺杆菌感染的患病率分别为61.7%和58.5%,差异无统计学意义(P = 0.577)。两组(糖尿病患者与非糖尿病患者)之间的糖尿病病程、空腹血糖和糖化血红蛋白水平、肾病和视网膜病变患病率差异均无统计学意义。60.3%的2型糖尿病患者无晚期并发症,其余患者至少有一种晚期并发症。幽门螺杆菌感染与神经病变的存在之间存在统计学显著相关性(P = 0.021)。

结论

糖尿病患者和非糖尿病对照组之间幽门螺杆菌感染的患病率差异无统计学意义。有趣的是,幽门螺杆菌感染的糖尿病患者神经病变的发生率较高,尽管糖尿病的病程和控制情况、视网膜病变、肾病与幽门螺杆菌感染状况之间无关联。

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