幽门螺杆菌感染、1型糖尿病和自身免疫性甲状腺炎之间的关联。

The association between Helicobacter pylori infection, type 1 diabetes mellitus, and autoimmune thyroiditis.

作者信息

Zekry Osama A, Abd Elwahid Hassan A

机构信息

Departments of aPediatrics bFamily Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

J Egypt Public Health Assoc. 2013 Dec;88(3):143-7. doi: 10.1097/01.EPX.0000437621.23560.de.

DOI:10.1097/01.EPX.0000437621.23560.de

PMID:24374947

Abstract

BACKGROUND

Type 1 diabetes mellitus (T1DM) can be associated with an increased prevalence of Helicobacter pylori infection, which could contribute to the pathogenesis of autoimmune thyroiditis observed in this disease.

AIM

The aim of this study was to assess the relationship between H. pylori infection and T1DM and to identify of the interconnection between H. pylori infection and autoimmune thyroiditis in patients with T1DM.

METHODS

A case-control design was used. The study group included 60 children and adolescents with T1DM who were selected from the pediatric outpatient clinic of Suez Canal University Hospital by a systematic random sampling method. The control group included 60 healthy children and adolescents matched for age and sex and selected from among relatives (brothers or cousins) of the patients with T1DM. The study participants were subjected to several investigations including estimation of levels of HbA1c, thyroid stimulating hormone (TSH), T3, T4, anti-thyroglobulin (anti-Tg), and anti-thyroid peroxidase (anti-TPO).

RESULTS

The mean age of the patients with T1DM was 12.53±2.35 years, whereas that of the control group was 12.30±1.98 years, with no statistically significant difference between the two groups. The patients with diabetes had significantly higher levels of H. pylori IgG, TSH, anti-TPO, and anti-Tg (20.43±14.84 μ/ml, 4.03±1.53 mIu/l, 14.98 ±5.04 Iu/ml, and 5.66±3.37 Iu/ml, respectively) and significantly lower levels of T3 and T4 (120±15.86 μg/dl and 4.93±0.93 μg/dl, respectively) compared with the control group. In addition, the seroprevalence rate of H. pylori, anti-Tg, and anti-TPO was significantly higher in diabetic patients, and the duration of diabetes was significantly longer in H. pylori-positive patients with higher levels of HbA1c, insulin requirement, TSH, anti-TPO, and anti-Tg.

CONCLUSION AND RECOMMENDATIONS

The association between H. pylori infection and autoimmune thyroiditis in patients with T1DM was revealed in this study. Hence, screening and treatment of H. pylori infection in T1DM patients is recommended.

摘要

背景

1型糖尿病（T1DM）可能与幽门螺杆菌感染率增加有关，这可能促成了该疾病中观察到的自身免疫性甲状腺炎的发病机制。

目的

本研究的目的是评估幽门螺杆菌感染与T1DM之间的关系，并确定T1DM患者中幽门螺杆菌感染与自身免疫性甲状腺炎之间的内在联系。

方法

采用病例对照设计。研究组包括60名患有T1DM的儿童和青少年，他们通过系统随机抽样方法从苏伊士运河大学医院儿科门诊选出。对照组包括60名年龄和性别相匹配的健康儿童和青少年，从T1DM患者的亲属（兄弟或表亲）中选出。研究参与者接受了多项检查，包括糖化血红蛋白（HbA1c）、促甲状腺激素（TSH）、T3、T4、抗甲状腺球蛋白（抗-Tg）和抗甲状腺过氧化物酶（抗-TPO）水平的测定。

结果

T1DM患者的平均年龄为12.53±2.35岁，而对照组为12.30±1.98岁，两组之间无统计学显著差异。糖尿病患者的幽门螺杆菌IgG、TSH、抗-TPO和抗-Tg水平显著更高（分别为20.43±14.84 μ/ml、4.03±1.53 mIu/l、14.98±5.04 Iu/ml和5.66±3.37 Iu/ml），与对照组相比，T3和T4水平显著更低（分别为120±15.86 μg/dl和4.93±0.93 μg/dl）。此外，糖尿病患者中幽门螺杆菌、抗-Tg和抗-TPO的血清阳性率显著更高，在HbA1c、胰岛素需求量、TSH、抗-TPO和抗-Tg水平较高的幽门螺杆菌阳性患者中，糖尿病病程显著更长。