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幽门螺杆菌与糖尿病:一种存在争议的关系。

Helicobacter pylori and diabetes mellitus: a controversial relationship.

作者信息

Valenzano Marina, Bisio Alessandro, Grassi Giorgio

机构信息

School of Specialization in Endocrinology and Metabolic Diseases, University of Turin, Turin, Italy -

Department of Endocrinology, Diabetology, and Metabolism, Città della Salute e della Scienza University Hospital, Turin, Italy -

出版信息

Minerva Endocrinol. 2019 Sep;44(3):301-309. doi: 10.23736/S0391-1977.19.03021-9.

Abstract

Research on Helicobacter pylori (H. pylori), a pathogenic bacterium that is widespread among humans, is investigating the medical implications of the infection in many fields beyond gastroenterology. Because of the ubiquitous presence of the infection, there is an increasing interest in finding a relationship between this bacterium and diabetes mellitus (DM). It is not clear whether a significant relation between H. pylori and DM exists, whether the infection influences diabetes or vice versa, and the mechanisms underlying such a relationship. This review provides an analysis of new insights from studies published in more recent years. New research on this topic concentrated on the common pathogenic aspects between the bacterium and insulin resistance or autoimmunity, on the role of the bacterial infection in cardiovascular risk and whether the infection worsen glycemic outcomes in patients with DM. Research in this field still has to conclusively assess and explain the existence of a possible relationship between H. pylori and DM. Some studies have reached antithetic conclusions. Unless more robust data from studies using consistent research methods become available in the near future, people with diabetes should be compared to the general population when it comes to investigating and treating the presence of H. pylori.

摘要

幽门螺杆菌(H. pylori)是一种在人类中广泛传播的致病细菌,对它的研究正在探索该感染在胃肠病学以外的许多领域的医学影响。由于这种感染普遍存在,人们越来越关注这种细菌与糖尿病(DM)之间的关系。目前尚不清楚幽门螺杆菌与糖尿病之间是否存在显著关系,感染是否会影响糖尿病,反之亦然,以及这种关系背后的机制。本综述分析了近年来发表的研究中的新见解。关于这个主题的新研究集中在该细菌与胰岛素抵抗或自身免疫之间的共同致病方面、细菌感染在心血管风险中的作用,以及感染是否会使糖尿病患者的血糖结果恶化。该领域的研究仍需最终评估并解释幽门螺杆菌与糖尿病之间可能存在的关系。一些研究得出了相反的结论。除非在不久的将来能获得更多来自采用一致研究方法的研究的有力数据,否则在调查和治疗幽门螺杆菌感染时,糖尿病患者应与普通人群进行比较。

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