Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan.
Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan.
J Clin Endocrinol Metab. 2017 Aug 1;102(8):2744-2750. doi: 10.1210/jc.2017-00257.
Both Helicobacter pylori and type 2 diabetes mellitus are possible risk factors for colon adenoma.
The purpose of this study was to assess the interaction between H. pylori and hyperglycemia status on the risk of colon adenoma.
DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional, retrospective study conducted at the MacKay Memorial Hospital, Taiwan. The study included 3943 subjects aged >40 years undergoing bidirectional gastrointestinal endoscopy on the same day between July 2006 and June 2015. All subjects had a gastric biopsy specimen tested for H. pylori.
Colon adenoma with and without H. pylori infection at different hemoglobin A1c (HbA1c) levels.
The prevalence of colorectal adenomas in patients who were H. pylori-positive and H. pylori-negative was 37.3% and 27.29%, respectively. Multivariate logistic regression analysis identified male sex, age, body mass index, H. pylori infection, and HbA1c ≥6.5% as independent risk factors for adenoma; use of hypoglycemic agents decreased this risk. The prevalence of adenoma was increased with elevated HbA1c levels regardless of H. pylori status. The odds ratio (OR) for adenoma was 1.44 (95% confidence interval [CI], 1.20 to 1.73) if H. pylori was present or 1.68 (95% CI, 1.05 to 2.70) in patients who were H. pylori-negative but had HbA1c ≥7.0%. If both conditions were present, the OR was 4.79 (95% CI, 2.92 to 7.84). A 1% increase in HbA1c was associated with an increased prevalence of adenoma by 42.4% in H. pylori-positive subjects.
The combination of H. pylori infection and elevated HbA1c is associated with an increased risk of colon adenoma.
幽门螺杆菌和 2 型糖尿病均可能是结直肠腺瘤的危险因素。
本研究旨在评估幽门螺杆菌（H. pylori）与高血糖状态之间的相互作用对结直肠腺瘤风险的影响。
设计、地点和参与者：这是一项在台湾马偕纪念医院进行的横断面、回顾性研究。该研究纳入了 2006 年 7 月至 2015 年 6 月间同日行双向胃肠内镜检查的 3943 例年龄＞40 岁的患者。所有患者均接受胃活检标本检测 H. pylori。
不同糖化血红蛋白（HbA1c）水平下伴有和不伴有 H. pylori 感染的结直肠腺瘤。
H. pylori 阳性和 H. pylori 阴性患者的结直肠腺瘤患病率分别为 37.3%和 27.29%。多变量 logistic 回归分析确定男性、年龄、体重指数、H. pylori 感染和 HbA1c≥6.5%为腺瘤的独立危险因素；使用降血糖药物可降低这种风险。无论 H. pylori 状态如何，随着 HbA1c 水平的升高，腺瘤的患病率均增加。如果存在 H. pylori，则腺瘤的比值比（OR）为 1.44（95%置信区间 [CI]，1.20 至 1.73）；如果 H. pylori 阴性但 HbA1c≥7.0%，OR 为 1.68（95% CI，1.05 至 2.70）。如果两种情况同时存在，OR 为 4.79（95% CI，2.92 至 7.84）。H. pylori 阳性患者中，HbA1c 每增加 1%，腺瘤的患病率增加 42.4%。
H. pylori 感染和 HbA1c 升高的组合与结直肠腺瘤风险增加相关。
