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幽门螺杆菌感染与高 HbA1c 和 2 型糖尿病相关。

Helicobacter pylori infection associated with high HbA1c and type 2 diabetes.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

Eur J Clin Invest. 2013 Sep;43(9):949-56. doi: 10.1111/eci.12124. Epub 2013 Jul 24.

Abstract

BACKGROUND

Although the association between chronic Helicobacter pylori infection and type 2 diabetes has been suggested, findings have been inconsistent. This study evaluated the association between chronic H. pylori infection and glucose regulation.

MATERIALS AND METHODS

We evaluated H. pylori infection status of participants recruited from the gastroenterology clinic at our hospital. At baseline, we performed blood tests including fasting plasma glucose, insulin, glycated haemoglobin A1c (HbA1c) and other biochemical measurements. Insulin resistance and beta-cell function were assessed by homoeostasis model assessment (HOMA-IR and HOMA-B, respectively).

RESULTS

A total of 2070 participants were recruited. Those who had H. pylori infections had higher serum HbA1c levels and lower HOMA-B than those who did not (5.78% vs. 5.69%, P = 0.01 and 53.85 + 38.43 vs. 60.64 + 43.40, P = 0.009, respectively). They also had a significantly higher prevalence of type 2 diabetes (8.97% vs. 5.57%, P= 0.02). Chronic H. pylori infection was significantly associated with high levels of HbA1c and type 2 diabetes in participants above 65 years old (P = 0.001) and decreased insulin secretion and sensitivity in those under 45 years (P = 0.05).

CONCLUSIONS

Long-term H. pylori infection is significantly associated with high levels of HbA1c and decreased insulin secretion in this Chinese population. Proper screening for H. pylori infection combined with regular monitoring of blood glucose and HbA1c levels might be effective for the early detection of glucose dysregulation and prevention of type 2 diabetes.

摘要

背景

虽然慢性幽门螺杆菌感染与 2 型糖尿病之间存在关联,但研究结果并不一致。本研究评估了慢性 H. pylori 感染与葡萄糖调节之间的关系。

材料和方法

我们评估了我院消化科门诊招募的参与者的 H. pylori 感染状况。在基线时,我们进行了包括空腹血浆葡萄糖、胰岛素、糖化血红蛋白 A1c(HbA1c)和其他生化测量在内的血液检测。通过稳态模型评估(HOMA-IR 和 HOMA-B)评估胰岛素抵抗和β细胞功能。

结果

共招募了 2070 名参与者。患有 H. pylori 感染的患者的血清 HbA1c 水平较高,HOMA-B 较低,而未感染的患者的 HbA1c 水平较低,HOMA-B 较高(5.78%比 5.69%,P=0.01;53.85+38.43 比 60.64+43.40,P=0.009)。他们也有更高的 2 型糖尿病患病率(8.97%比 5.57%,P=0.02)。在年龄超过 65 岁的参与者中,慢性 H. pylori 感染与 HbA1c 水平升高和 2 型糖尿病显著相关(P=0.001),而在年龄小于 45 岁的参与者中,慢性 H. pylori 感染与胰岛素分泌减少和敏感性降低显著相关(P=0.05)。

结论

在中国人群中,长期 H. pylori 感染与 HbA1c 水平升高和胰岛素分泌减少显著相关。对 H. pylori 感染进行适当筛查并定期监测血糖和 HbA1c 水平可能有助于早期发现血糖失调和预防 2 型糖尿病。

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