Pan Bo-Lin, Huang Chih-Fang, Chuah Seng-Kee, Chiang Jui-Chin, Loke Song-Seng
Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung, 833, Taiwan.
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung, 833, Taiwan.
BMC Gastroenterol. 2018 Apr 24;18(1):54. doi: 10.1186/s12876-018-0780-4.
Helicobacter pylori (H. pylori) infection can induce individual inflammatory and immune reactions which associated with extra-digestive disorders. Our aim is to investigate the association between H. pylori infection and bone mineral density.
This retrospective cross-sectional study was performed by using the data from the health examination database in a medical center of southern Taiwan in 2013. We investigated the relationship between sex, age, body mass index (BMI), waist circumstance, lipid profile, H. pylori infection, the findings of upper gastrointestinal endoscopy and bone mineral density (BMD). Because of nonrandomized assignment and strong confounding effect of age on BMD, the 1:1 propensity score match was applied for age adjustment. The simple and multiple stepwise logistic regression analysis were performed to assess the risk factors of decreased BMD in these well-balanced pairs of participants.
Of the 867 subjects in final analysis with the mean age of 55.9 ± 11.3 years, 381 (43.9%) subjects had H. pylori infection, and 556 (64.1%) subjects had decreased BMD. In decreased BMD group, the portion of woman was higher than a normal BMD group (37.2% versus 29.6%, P = 0.023), the age was significantly older (59.4 ± 9.8 versus 49.8 ± 11.3, p < 0.001) and BMI was significantly lower (24.7 ± 3.5 versus 25.4 ± 3.7, p = 0.006) than the normal BMD group. The prevalence of H. pylori infection was 39.9% and 46.2% in the normal BMD group and the decreased BMD group respectively (P = 0.071). The multivariate analysis which was used for these possible risk factors showed that only advanced age (OR 1.09, 95% CI 1.08-1.11, P < 0.001), and low BMI (OR 0.91, 95% CI 0.87-0.95, P < 0.001) were independently significantly associated with decreased BMD in this nonrandomized study. In the propensity score-matched participants, the multiple stepwise logistic regression analysis revealed H. pylori infection (OR 1.62, 95% CI 1.12-2.35, P = 0.011) and low BMI (OR 0.92, 95% CI 0.87-0.97, P = 0.001) were independently significantly associated with decreased BMD.
H. pylori infection and low BMI were independently significantly associated with decreased BMD in selected propensity score-matched populations after age adjustment.
幽门螺杆菌（H. pylori）感染可引发个体炎症和免疫反应，这些反应与消化系统外疾病相关。我们的目的是研究幽门螺杆菌感染与骨密度之间的关联。
本回顾性横断面研究使用了2013年台湾南部某医疗中心健康检查数据库中的数据。我们调查了性别、年龄、体重指数（BMI）、腰围、血脂谱、幽门螺杆菌感染、上消化道内镜检查结果与骨密度（BMD）之间的关系。由于存在非随机分配以及年龄对骨密度的强烈混杂效应，因此采用1:1倾向评分匹配法进行年龄调整。对这些平衡良好的参与者对进行单因素和多因素逐步逻辑回归分析，以评估骨密度降低的危险因素。
在最终分析的867名平均年龄为55.9±11.3岁的受试者中，381名（43.9%）受试者感染幽门螺杆菌，556名（64.1%）受试者骨密度降低。在骨密度降低组中，女性比例高于骨密度正常组（37.2%对29.6%，P = 0.023），年龄显著更大（59.4±9.8对49.8±11.3，p < 0.001），BMI显著更低（24.7±3.5对25.4±3.7，p = 0.006）。骨密度正常组和骨密度降低组中幽门螺杆菌感染的患病率分别为39.9%和46.2%（P = 0.071）。对这些可能的危险因素进行多因素分析显示，在这项非随机研究中，仅高龄（OR 1.09，95%CI 1.08 - 1.11，P < 0.001）和低BMI（OR 0.91，95%CI 0.87 - 0.95，P < 0.001）与骨密度降低独立显著相关。在倾向评分匹配的参与者中，多因素逐步逻辑回归分析显示幽门螺杆菌感染（OR 1.62，95%CI 1.12 - 2.35，P = 0.011）和低BMI（OR 0.92，95%CI 0.87 - 0.97，P = 0.001）与骨密度降低独立显著相关。
在经过年龄调整的选定倾向评分匹配人群中，幽门螺杆菌感染和低BMI与骨密度降低独立显著相关。
