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幽门螺杆菌感染作为血清胆红素变化和血脂谱更不利的危险因素:一项基于医院的健康体检调查。

Helicobacter pylori infection as a risk factor for serum bilirubin change and less favourable lipid profiles: a hospital-based health examination survey.

机构信息

Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.

Edgar Diabetes and Obesity Research Centre, University of Otago, Wellington, New Zealand.

出版信息

BMC Infect Dis. 2019 Feb 14;19(1):157. doi: 10.1186/s12879-019-3787-8.

Abstract

BACKGROUND

Helicobacter pylori infection is associated with several extragastric conditions including dyslipidemia and metabolic syndrome. This study aimed to investigate additional metabolic parameters associated with H. pylori infection in a Chinese population.

METHODS

Using a case-control approach we studied 617 subjects with C-urea breath test (C-UBT) values ≥10‰ who were defined as being positive for H. pylori (cases), while 617 sex and age- matched subjects with C-UBT values ≤1‰ were defined as H. pylori negative (controls) in Beijing Tongren Hospital from March 2016 to May 2017. Biochemical parameters including serum bilirubin and lipids were tested.

RESULTS

A total of 1982 subjects participated in this study. The H. pylori infected subjects had significantly lower serum direct bilirubin concentrations (2.34 ± 0.38 vs. 2.47 ± 0.90 μmol/L, P = 0.008). H. pylori infection was independently associated with lower direct bilirubin levels (OR = 1.497, 95% CI =1.121-1.999, P = 0.006) or total bilirubin levels (OR = 1.322, 95% CI =1.005-1.738, P = 0.046) after adjustment for age, sex, body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) and triglycerides(TG). In addition, the H. pylori infected subjects had higher LDL-C levels (2.98 ± 0.76 vs. 2.89 ± 0.75 mmol/L, P = 0.033) and lower HDL-C levels (1.39 ± 0.37 vs. 1.44 ± 0.41 mmol/L, P = 0.044). LDL-C was negatively correlated with direct bilirubin concentration (R = - 0.260, P < 0.0001).

CONCLUSIONS

Bilirubin has been found to be a potent endogenous antioxidant and negatively associated with metabolic syndrome. Our results suggest that H. pylori infection is an independent risk factor for serum bilirubin reduction and less favorable lipid profiles.

摘要

背景

幽门螺杆菌感染与多种胃肠道外疾病相关,包括血脂异常和代谢综合征。本研究旨在调查中国人群中与幽门螺杆菌感染相关的其他代谢参数。

方法

采用病例对照研究方法,我们研究了 2016 年 3 月至 2017 年 5 月在北京同仁医院接受 C-尿素呼气试验(C-UBT)检测的 617 例 C-UBT 值≥10‰的患者,将这些患者定义为幽门螺杆菌阳性(病例组),同时选取了 617 例 C-UBT 值≤1‰的性别和年龄匹配的患者作为幽门螺杆菌阴性(对照组)。检测了血清胆红素和脂质等生化参数。

结果

共纳入 1982 例受试者。与幽门螺杆菌阴性者相比,幽门螺杆菌感染者的血清直接胆红素浓度明显降低(2.34±0.38 vs. 2.47±0.90μmol/L,P=0.008)。经年龄、性别、体重指数(BMI)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)和三酰甘油(TG)校正后,幽门螺杆菌感染与直接胆红素(OR=1.497,95%CI=1.121-1.999,P=0.006)或总胆红素(OR=1.322,95%CI=1.005-1.738,P=0.046)水平降低独立相关。此外,幽门螺杆菌感染者的 LDL-C 水平升高(2.98±0.76 vs. 2.89±0.75mmol/L,P=0.033),HDL-C 水平降低(1.39±0.37 vs. 1.44±0.41mmol/L,P=0.044)。LDL-C 与直接胆红素浓度呈负相关(R=-0.260,P<0.0001)。

结论

胆红素是一种有效的内源性抗氧化剂,与代谢综合征呈负相关。我们的研究结果表明,幽门螺杆菌感染是血清胆红素降低和血脂谱恶化的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ea4/6376701/b0fb464e1d89/12879_2019_3787_Fig1_HTML.jpg

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