Wu Shou-En, Chen Wei-Liang
Department of Dermatology, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Gut Pathog. 2021 Nov 15;13(1):67. doi: 10.1186/s13099-021-00464-y.
Helicobacter pylori (H. pylori), Gram negative microaerophilic bacteria, is a well-known pathogen of many gastrointestinal diseases. But several emerging evidences suggest it role in numerous other extra-gastric diseases. The current study investigates the relationship between H. pylori infection and sarcopenia, a clinical condition characterized by the loss of mass and function of skeletal muscle. A total of 3453 eligible participants from the Third National Health and Nutrition Examination Survey (NHANES III), the United States, were enrolled. Based on the serum laboratory results, subjects were categorized into three groups: normal (without evidence of any H. pylori infection), anti-H. pylori IgG positive [H. pylori (+)], and concurrent anti-H. pylori IgG and anti-cytotoxin-associated gene A IgG positive [CagA (+)]. Sarcopenia was determined as having a skeletal muscle index (SMI) value that is more than 1 standard deviation away from the mean value of sex-specific, healthy young adults between 20 and 39 years old. Risk of sarcopenia and its components are compared between subgroups.
Odds ratios (OR) for confirmed diagnosis of sarcopenia were higher in H. pylori (+) (OR = 2.052, 95% CI 1.697-2.481, p < 0.001) and CagA (+) (OR = 1.585, 95% CI 1.278-1.965, p < 0.001) groups. Moreover, negative beta regression coefficient of SMI were shown in H. pylori (+) (β: - 0.023, p < 0.001) and CagA (+) (β: - 0.017, p < 0.001). Sub-analyses which categorized participants by gender revealed that absolute value of beta regression coefficient for SMI were higher in female in H. pylori (+) subgroup (β: - 1.745 in male and - 2.942 in female, p were both < 0.001), and the CagA (+) subgroup (β: - 1.407 in male and - 2.159 in female, p were both < 0.001).
Positive serum H. pylori infectious markers including anti-H. pylori antibody and CagA seropositivity are correlated with sarcopenia and low muscle quantity. Therefore, H. pylori eradication therapy may bring benefits to sarcopenia patients with concurrent active H. pylori infection.
幽门螺杆菌(H. pylori)是革兰氏阴性微需氧菌,是许多胃肠道疾病的著名病原体。但一些新出现的证据表明其在许多其他胃外疾病中也有作用。本研究调查幽门螺杆菌感染与肌肉减少症之间的关系,肌肉减少症是一种以骨骼肌质量和功能丧失为特征的临床病症。纳入了来自美国第三次全国健康和营养检查调查(NHANES III)的3453名符合条件的参与者。根据血清实验室结果,受试者被分为三组:正常组(无任何幽门螺杆菌感染证据)、抗幽门螺杆菌IgG阳性[幽门螺杆菌(+)]组以及抗幽门螺杆菌IgG和抗细胞毒素相关基因A IgG同时阳性[CagA(+)]组。肌肉减少症的判定标准为骨骼肌指数(SMI)值比20至39岁性别特异性健康年轻成年人的平均值偏离超过1个标准差。比较各亚组之间肌肉减少症及其组成部分的风险。
幽门螺杆菌(+)组(比值比[OR]=2.052,95%置信区间[CI] 1.697 - 2.481,p<0.001)和CagA(+)组(OR = 1.585,95% CI 1.278 - 1.965,p<0.001)确诊肌肉减少症的比值比更高。此外,幽门螺杆菌(+)组(β: - 0.023,p<0.001)和CagA(+)组(β: - 0.017,p<0.001)的SMI呈现负向β回归系数。按性别对参与者进行分类的亚组分析显示,幽门螺杆菌(+)亚组中女性的SMIβ回归系数绝对值更高(男性为 - 1.745,女性为 - 2.942,p均<0.001),CagA(+)亚组中也是如此(男性为 - 1.407,女性为 - 2.159,p均<0.001)。
包括抗幽门螺杆菌抗体和CagA血清阳性在内的血清幽门螺杆菌感染阳性标志物与肌肉减少症和低肌肉量相关。因此,根除幽门螺杆菌治疗可能会给同时患有活动性幽门螺杆菌感染的肌肉减少症患者带来益处。