Health Management Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Sci Rep. 2017 Jan 3;7:39777. doi: 10.1038/srep39777.
Gastric atrophy results in lower plasma ghrelin, higher gastrin secretion, a change in gut microbiota, and altered dietary nutrient absorption, which may be associated with the incidence of diabetes. Helicobacter pylori (H. pylori) infection is a major cause of gastric atrophy and is associated with diabetes in some reports. Since there is no study which investigates the impact of gastric atrophy on diabetes, we conduct a prospective cohort study to examine the relationship between H. pylori infection, gastric atrophy, and incident diabetes. In this study, subjects with gastric atrophy had a lower risk of incident diabetes, compared to those without gastric atrophy. The extent of gastric atrophy, measured by serum pepsinogen (PG) I/II ratio, was correlated with age, H. pylori IgG titer, HOMA2-IR, and HOMA2%B. When gastric atrophy is more extensive, presented as a lower serum PG I/II ratio, the risk of incident diabetes is lower. On the other hand, there was no significant association between H. pylori infection and the incidence of diabetes. In conclusion, the presence and the extent of gastric atrophy, but not H. pylori infection, are associated with incident diabetes. Further studies are needed to investigate the detailed mechanisms and the potential applications of the findings to guide diabetes screening and treatment strategies.
胃萎缩导致血浆胃饥饿素降低、胃泌素分泌增加、肠道微生物群改变和膳食营养素吸收改变，这些可能与糖尿病的发生有关。幽门螺杆菌（H. pylori）感染是胃萎缩的主要原因，在一些报告中与糖尿病有关。由于没有研究调查胃萎缩对糖尿病的影响，我们进行了一项前瞻性队列研究，以检查 H. pylori 感染、胃萎缩和糖尿病发病之间的关系。在这项研究中，与无胃萎缩的患者相比，胃萎缩患者发生糖尿病的风险较低。通过血清胃蛋白酶原（PG）I/II 比值测量的胃萎缩程度与年龄、H. pylori IgG 滴度、HOMA2-IR 和 HOMA2%B 相关。当胃萎缩更广泛，表现为血清 PG I/II 比值降低时，发生糖尿病的风险更低。另一方面，H. pylori 感染与糖尿病的发生之间没有显著关联。总之，胃萎缩的存在和程度与糖尿病的发生有关，但 H. pylori 感染则没有。需要进一步的研究来探讨其详细的机制以及这些发现对指导糖尿病筛查和治疗策略的潜在应用。
