Suki Mohamad, Leibovici Weissman Yaara, Boltin Doron, Itskoviz David, Tsadok Perets Tsachi, Comaneshter Doron, Cohen Arnon, Niv Yaron, Dotan Iris, Leibovitzh Haim, Levi Zohar
Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, PetachTikva.
Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Gastroenterol Hepatol. 2018 Feb;30(2):143-148. doi: 10.1097/MEG.0000000000001014.
Data on the association of Helicobacter pylori infection and BMI are conflicting. The fact that both H. pylori infection and BMI are associated with low socioeconomic status (SES) makes this relationship difficult to characterize.
We aimed to evaluate the association between BMI and H. pylori infection after adjusting for multiple covariates. We analyzed a cohort of 235 107 individuals aged 18 years or older, who performed a C urease breath test (C-UBT), from 2007 to 2014. Data on BMI, age, sex, SES, ethnicity, and medications were extracted from a nationwide population-based database. BMIs were classified according to the WHO recommendations: underweight (<18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25-29.9 kg/m), obese class I (30-34.9 kg/m), and obese class II or more (>35 kg/m).
The positivity rate for H. pylori among underweight, normal weight, overweight, and obese class I and class II or more was 55.6, 58.5, 63.0, 64.5, and 65.5%, respectively (P<0.001, Plinear trend 0.007). The association between BMI and H. pylori infection was significant across all SES, sex, ethnicity, and age categories. After adjusting for age, sex, ethnicity, and SES, being overweight and obese class I and class II or more were associated significantly with H. pylori positivity: odds ratio 1.13 [95% confidence interval (CI): 1.11-1.15], 1.14 (95% CI: 1.11-1.17), and 1.15 (95% CI: 1.11-1.19), respectively, P value less than 0.001 for all.
Among individuals who were referred to a C-UBT by primary care physician, after adjusting for multiple covariates including SES, we found a positive association between H. pylori infection and an increased BMI.
幽门螺杆菌感染与体重指数（BMI）之间关联的数据存在矛盾。幽门螺杆菌感染和BMI均与社会经济地位（SES）较低有关，这使得这种关系难以描述。
我们旨在在调整多个协变量后评估BMI与幽门螺杆菌感染之间的关联。我们分析了2007年至2014年间235107名18岁及以上进行了尿素呼气试验（C-UBT）的个体队列。从全国性的基于人群的数据库中提取了有关BMI、年龄、性别、SES、种族和药物治疗的数据。BMI根据世界卫生组织的建议进行分类：体重过轻（<18.5kg/m²）、正常体重（18.5 - 24.9kg/m²）、超重（25 - 29.9kg/m²）、I级肥胖（30 - 34.9kg/m²）以及II级及以上肥胖（>35kg/m²）。
体重过轻、正常体重、超重、I级肥胖以及II级及以上肥胖个体中幽门螺杆菌的阳性率分别为55.6%、58.5%、63.0%、64.5%和65.5%（P<0.001，线性趋势P = 0.007）。在所有SES、性别、种族以及年龄类别中，BMI与幽门螺杆菌感染之间的关联均显著。在调整年龄、性别、种族和SES后，超重以及I级和II级及以上肥胖与幽门螺杆菌阳性显著相关：比值比分别为1.13 [95%置信区间（CI）：1.11 - 1.15]、1.14（95%CI：1.11 - 1.17）和1.15（95%CI：1.11 - 1.19），所有P值均小于0.001。
在由初级保健医生转诊进行C-UBT的个体中，在调整包括SES在内的多个协变量后，我们发现幽门螺杆菌感染与BMI升高之间存在正相关。
