Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece.
First Department of Pharmacology, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece.
Metabolism. 2018 Oct;87:18-24. doi: 10.1016/j.metabol.2018.06.008. Epub 2018 Jun 21.
Both Helicobacter pylori infection and metabolic syndrome present significant global public health burdens. Metabolic syndrome is closely related to insulin resistance, the major underlying mechanism responsible for metabolic abnormalities, and Helicobacter pylori infection has been proposed to be a contributing factor. There is growing evidence for a potential association between Helicobacter pylori infection and insulin resistance, metabolic syndrome and related morbidity, including abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, all of which increase mortality related to cardio-cerebrovascular disease, neurodegenerative disorders, nonalcoholic fatty liver disease and malignancies. More specifically, insulin resistance, metabolic syndrome and hyperinsulinemia have been associated with upper and lower gastrointestinal tract oncogenesis. Apart from cardio-cerebrovascular, degenerative diseases and nonalcoholic fatty liver disease, a number of studies claim that Helicobacter pylori infection is implicated in metabolic syndrome-related Barrett's esophagus and esophageal adenocarcinoma development, gastric and duodenal ulcers and gastric oncogenesis as well as lower gastrointestinal tract oncogenesis. This review summarizes evidence on the potential impact of Helicobacter pylori-related metabolic syndrome on gastroesophageal reflux disease-Barrett's esophagus-esophageal adenocarcinoma, gastric atrophy-intestinal metaplasia-dysplasia-gastric cancer and colorectal adenoma-dysplasia-colorectal cancer sequences. Helicobacter pylori eradication might inhibit these oncogenic processes, and thus further studies are warranted.
幽门螺杆菌感染和代谢综合征都对全球公共卫生造成了重大负担。代谢综合征与胰岛素抵抗密切相关，胰岛素抵抗是导致代谢异常的主要潜在机制，而幽门螺杆菌感染被认为是一个促成因素。越来越多的证据表明，幽门螺杆菌感染与胰岛素抵抗、代谢综合征及其相关发病率之间存在潜在关联，包括腹型肥胖、2 型糖尿病、血脂异常、高血压，所有这些都增加了与心脑血管疾病、神经退行性疾病、非酒精性脂肪性肝病和恶性肿瘤相关的死亡率。更具体地说，胰岛素抵抗、代谢综合征和高胰岛素血症与上消化道和下消化道的肿瘤发生有关。除了心脑血管疾病、退行性疾病和非酒精性脂肪性肝病外，许多研究还声称，幽门螺杆菌感染与代谢综合征相关的巴雷特食管和食管腺癌发展、胃和十二指肠溃疡以及胃癌和下消化道肿瘤发生有关。本综述总结了幽门螺杆菌相关代谢综合征对胃食管反流病-巴雷特食管-食管腺癌、胃萎缩-肠上皮化生-异型增生-胃癌和结直肠腺瘤-异型增生-结直肠癌序列的潜在影响的证据。幽门螺杆菌的根除可能会抑制这些致癌过程，因此需要进一步的研究。
