Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, PR China; Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China.
Department of Gastroenterology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China.
Diabetes Res Clin Pract. 2015 Dec;110(3):328-34. doi: 10.1016/j.diabres.2015.09.008. Epub 2015 Sep 25.
The aim of this conventional case-control study was to investigate the prevalence and relationship between Helicobacter pylori infection in type 2 diabetes mellitus (DM) and diabetic nephropathy (DN).
A total of 241 type 2 DM patients and 69 non-diabetic subjects with dyspeptic symptoms were enrolled in the study. Gastroduodenal lesions were observed by gastrointestinal endoscopy and the presence of H. pylori was identified by rapid urease test and serum IgG antibodies to H. pylori. According to the urinary albumin excretion rate (UAE), patients were classified into diabetes mellitus group (DM group, with UAE <30 mg/24h); diabetic nephropathy group 1 (DN group 1, with UAE 30 mg/24 h to <300 mg/24 h); and diabetic nephropathy group 2 (DN group 2 ≥ 300 mg/24 h). The 69 non-diabetic subjects were used as control group. The serum levels of inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin (IL)-8 were determined using ELISA.
The prevalence of H. pylori infection in DN group 1 and DN group 2 was 45/72 (62.5%) and 34/53 (64.15%), respectively, which was significantly higher than in control [28/65 (43.1%)] and DM groups [42.9% (27/63)]. No significant differences of H. pylori prevalence were detected between DN groups as well as DM and control groups. Interestingly, in both DN groups, higher levels of IL-8, TNF-α and urinary albumin excretion rate were found in H. pylori positive subjects.
Diabetic nephropathy patients are more susceptible to H. pylori infection. Our data support an association between H. pylori infection and diabetic nephropathy.
本常规病例对照研究旨在探讨 2 型糖尿病（DM）和糖尿病肾病（DN）患者中幽门螺杆菌（H. pylori）感染的流行率及其相关性。
共纳入 241 例 2 型 DM 患者和 69 例有消化不良症状的非糖尿病患者。通过胃肠内窥镜观察胃十二指肠病变，通过快速尿素酶试验和血清 H. pylori IgG 抗体确定 H. pylori 的存在。根据尿白蛋白排泄率（UAE），将患者分为糖尿病组（DM 组，UAE<30mg/24h）；糖尿病肾病 1 组（DN 组 1，UAE 30mg/24h 至<300mg/24h）；糖尿病肾病 2 组（DN 组 2≥300mg/24h）。69 例非糖尿病患者作为对照组。采用 ELISA 法测定肿瘤坏死因子-α（TNF-α）和白细胞介素（IL）-8 等炎症因子的血清水平。
DN 组 1 和 DN 组 2 的 H. pylori 感染率分别为 45/72（62.5%）和 34/53（64.15%），明显高于对照组[28/65（43.1%）]和 DM 组[42.9%（27/63）]。DN 组之间、DM 组和对照组之间 H. pylori 感染率无显著差异。有趣的是，在 DN 两组中，H. pylori 阳性患者的 IL-8、TNF-α 和尿白蛋白排泄率水平更高。
糖尿病肾病患者更易感染 H. pylori。我们的数据支持 H. pylori 感染与糖尿病肾病之间存在关联。
