Moretti Elena, Gonnelli Stefano, Campagna Mariastella, Nuti Ranuccio, Collodel Giulia, Figura Natale
Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
Intern Emerg Med. 2014 Oct;9(7):767-72. doi: 10.1007/s11739-013-1043-6. Epub 2014 Jan 14.
Helicobacter pylori infection may contribute to the development of extra-gastroduodenal diseases. The aim of this study was to explore whether this infection could influence metabolic parameters and body composition of dyslipidemic patients. In an 8-month period, 155 patients attended our clinic; 110 patients (48 men and 62 women, age 35-55 years) fulfilled inclusion criteria. Metabolic parameters were determined by routine tests and body composition by anthropometry and bioelectrical impedance analysis. The H. pylori and CagA infectious status were examined serologically. Sixty-one patients (55.4%) had serum antibodies to H. pylori and 30 infected patients (49.1%) had anti-CagA antibodies. The mean percentage of fat mass and level of high-density protein cholesterol in seropositive patients were significantly lower than those measured in seronegative ones (P = 0.008 and P < 0.001, respectively). The mean glucose concentration in patients with anti-H. pylori serum IgG was significantly higher than in uninfected patients (P = 0.021). No significant difference was observed regarding the other parameters. The CagA status did not influence any of the considered parameters. Our results are in agreement with those of other studies; however, the level of concordance of results reported in the various publications on this topic is very low, presumably from differences concerning the age, alimentary habits and possible presence of different pathologies in the groups studied. The most plausible hypothesis for the observed alterations may exist in the low-grade systemic inflammatory status of infected individuals, which may influence the fat turnover and support the insulin resistance with consequent alteration of glucose metabolism.
幽门螺杆菌感染可能会促使胃十二指肠外疾病的发生。本研究的目的是探究这种感染是否会影响血脂异常患者的代谢参数和身体组成。在8个月的时间里,有155名患者到我们诊所就诊;110名患者(48名男性和62名女性,年龄在35至55岁之间)符合纳入标准。通过常规检测确定代谢参数,通过人体测量和生物电阻抗分析确定身体组成。采用血清学方法检测幽门螺杆菌和细胞毒素相关蛋白A(CagA)的感染状况。61名患者(55.4%)血清中有幽门螺杆菌抗体,30名感染患者(49.1%)有抗CagA抗体。血清阳性患者的平均体脂百分比和高密度脂蛋白胆固醇水平显著低于血清阴性患者(分别为P = 0.008和P < 0.001)。抗幽门螺杆菌血清IgG患者的平均血糖浓度显著高于未感染患者(P = 0.021)。在其他参数方面未观察到显著差异。CagA状态对任何所考虑的参数均无影响。我们的结果与其他研究一致;然而,关于该主题的各种出版物中报道的结果一致性水平非常低,推测是由于所研究组在年龄、饮食习惯以及可能存在的不同病理状况方面存在差异。对于所观察到的改变,最合理的假设可能存在于受感染个体的低度全身炎症状态中,这可能会影响脂肪代谢周转并支持胰岛素抵抗,从而导致葡萄糖代谢改变。