Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Helicobacter. 2021 Apr;26(2):e12783. doi: 10.1111/hel.12783. Epub 2021 Jan 28.
Previous studies have suggested a relationship between Helicobacter pylori infection and dyslipidemia; however, large-scale longitudinal studies have not elucidated this association. This study assessed the longitudinal effects of H. pylori infection and eradication on lipid profiles in a large cohort.
This cohort study included 2,626 adults without dyslipidemia at baseline, who participated in a repeated, regular health-screening examination, which included upper gastrointestinal endoscopy, between January 2009 and December 2018. The primary outcome was incident dyslipidemia at follow-up.
During the 10,324 person-years of follow-up, participants with persistent H. pylori infection had a higher incidence rate (130.5 per 1,000 person-years) of dyslipidemia than those whose infections had been successfully controlled (98.1 per 1,000 person-years). In a multivariable model adjusted for age, sex, waist circumference, smoking status, alcohol intake, and education level, the H. pylori eradication group was associated with a lower risk of dyslipidemia than the persistent group (HR, 0.85; 95% CI, 0.77-0.95; p = 0.004). The association persisted after further adjustment for baseline levels of low-density and high-density lipoprotein cholesterol (HR, 0.87; 95% CI, 0.79-0.97; p = 0.014).
H. pylori infection may play a pathophysiologic role in the development of dyslipidemia, whereas H. pylori eradication might decrease the risk of dyslipidemia.
先前的研究表明，幽门螺杆菌感染与血脂异常之间存在关联；然而，大规模的纵向研究尚未阐明这种关联。本研究评估了幽门螺杆菌感染和根除对大型队列血脂谱的纵向影响。
本队列研究纳入了 2626 名基线时无血脂异常的成年人，他们参加了 2009 年 1 月至 2018 年 12 月期间重复的定期健康筛查检查，包括上消化道内镜检查。主要结局是随访时发生血脂异常。
在 10324 人年的随访期间，持续感染幽门螺杆菌的参与者血脂异常的发生率（130.5/1000 人年）高于感染已被成功控制的参与者（98.1/1000 人年）。在调整了年龄、性别、腰围、吸烟状态、饮酒和教育水平的多变量模型中，幽门螺杆菌根除组发生血脂异常的风险低于持续感染组（HR，0.85；95%CI，0.77-0.95；p=0.004）。在进一步调整了基线时的低密度和高密度脂蛋白胆固醇水平后，这种关联仍然存在（HR，0.87；95%CI，0.79-0.97；p=0.014）。
幽门螺杆菌感染可能在血脂异常的发生发展中起病理生理作用，而幽门螺杆菌根除可能降低血脂异常的风险。
