Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, China; Center for Precision Medicine and Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA.
Department of Health Management, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
Atherosclerosis. 2019 Dec;291:71-77. doi: 10.1016/j.atherosclerosis.2019.10.005. Epub 2019 Oct 11.
Atherosclerosis is an important contributing factor to cardiovascular mortality. The role of Helicobacter pylori (H. pylori) infection in atherosclerosis is inconsistent and sometimes controversial. The present study aimed to determine if H. pylori infection is associated with carotid atherosclerosis.
17,613 males and females with both carotid ultrasonic examination and C-urea breath test for H. pylori infection were screened by a major Chinese university hospital from March 2012 to March 2017 for the study. Baseline demographics, cardiac risk factors, and laboratory studies were obtained. After exclusion for pre-specified conditions, 12,836 individuals were included in the analysis, including 8157 men (63.5%) and 4679 women (36.5%). Analysis was also made for 5-year follow-up data of 1216 subjects (869 males and 347 females) with and without H. pylori infection for development and progression of carotid atherosclerosis.
After adjusting for age, sex, body mass index, lipid profile, hypertension, renal function, diabetes mellitus, and smoking, H. pylori infection was found as an independent risk factor for carotid atherosclerosis in males under 50 years, but not in older males or females (odds ratio 1.229, 95% CI 1.054-1.434, p = 0.009). Follow-up data analysis showed that the incidence of carotid atherosclerosis from no atherosclerosis to detectable lesions was significantly higher in young males with persistent H. pylori infection than those without H. pylori infection (p = 0.028) after 3 years.
These data suggest that H. pylori infection might be an important risk factor for carotid atherosclerosis in young Chinese males under 50.
动脉粥样硬化是心血管死亡率的一个重要致病因素。幽门螺杆菌（H. pylori）感染与动脉粥样硬化的关系尚不一致，有时甚至存在争议。本研究旨在确定 H. pylori 感染是否与颈动脉粥样硬化相关。
本研究通过中国一所大型医院，于 2012 年 3 月至 2017 年 3 月对 17613 例同时接受颈动脉超声检查和 C-尿素呼气试验检测 H. pylori 感染的男性和女性进行了筛选。获取了基线人口统计学、心脏危险因素和实验室研究数据。排除了预先指定的情况后，共纳入 12836 例个体，其中 8157 例男性（63.5%）和 4679 例女性（36.5%）。还对 1216 例（869 例男性和 347 例女性）有无 H. pylori 感染的个体进行了 5 年随访数据的分析，以了解颈动脉粥样硬化的发生和进展情况。
在调整了年龄、性别、体重指数、血脂谱、高血压、肾功能、糖尿病和吸烟等因素后，发现 H. pylori 感染是 50 岁以下男性颈动脉粥样硬化的独立危险因素，但在年龄较大的男性或女性中则不是（比值比 1.229，95%置信区间 1.054-1.434，p=0.009）。随访数据分析显示，在持续 H. pylori 感染的年轻男性中，从无动脉粥样硬化到可检测到病变的颈动脉粥样硬化发生率明显高于无 H. pylori 感染的男性（p=0.028），随访时间为 3 年。
这些数据表明，H. pylori 感染可能是中国 50 岁以下年轻男性颈动脉粥样硬化的一个重要危险因素。
