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根除幽门螺杆菌对 2 型糖尿病或糖尿病前期患者血红蛋白 A1c 的长期影响。

Long-term effect of the eradication of Helicobacter pylori on the hemoglobin A1c in type 2 diabetes or prediabetes patients.

机构信息

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Korean J Intern Med. 2022 May;37(3):579-590. doi: 10.3904/kjim.2021.194. Epub 2022 Jan 7.

Abstract

BACKGROUND/AIMS: The long-term effect of Helicobacter pylori eradication on the metabolic syndrome or diabetes are unclear. The aim of this study was to evaluate the effect of H. pylori eradication on glycemic control in type 2 diabetes mellitus (T2DM) or prediabetes mellitus (preDM).

METHODS

A total of 124 asymptomatic subjects with T2DM or preDM were divided into H. pylori-negative (n = 40), H. pylori-positive with non-eradicated (n = 34), and eradicated (n = 50) groups. We measured H. pylori status (culture, histology, and rapid urease test) and glycated hemoglobin A1c (A1C) levels and followed-up at the 1st year and the 5th year of follow-up.

RESULTS

The A1C levels significantly decreased in the eradicated group compared to the negative group and the non-eradicated groups (at the 1st year, p = 0.024; at the 5th year, p = 0.009). The A1C levels decreased in male, and/or subjects < 65 years of age in subgroup analyses (in male subjects, p = 0.047 and p = 0.020 at the 1st and the 5th year; in subjects < 65 years of age, p = 0.028 and p = 0.006 at the 1st and the 5th year; in male subjects < 65 years of age, p = 0.039 and p = 0.032 at the 1st and the 5th year). The eradication of H. pylori was related to the decrease in A1C values throughout the follow-up period, compared to the non-eradicated group (p = 0.017).

CONCLUSION

H. pylori eradication was related to the decreasing of A1C levels in patients with T2DM or preDM over a long-term follow-up period, especially in male and subjects < 65 years of age.

摘要

背景/目的:目前尚不清楚幽门螺杆菌(H. pylori)根除治疗对代谢综合征或糖尿病的长期影响。本研究旨在评估 H. pylori 根除治疗对 2 型糖尿病(T2DM)或糖尿病前期(preDM)患者血糖控制的影响。

方法

共有 124 例无症状的 T2DM 或 preDM 患者被分为 H. pylori 阴性组(n = 40)、H. pylori 阳性但未根除组(n = 34)和根除组(n = 50)。我们检测了 H. pylori 状态(培养、组织学和快速尿素酶试验)和糖化血红蛋白 A1c(A1C)水平,并在第 1 年和第 5 年进行了随访。

结果

与 H. pylori 阴性组和未根除组相比,根除组的 A1C 水平显著降低(第 1 年,p = 0.024;第 5 年,p = 0.009)。在亚组分析中,A1C 水平在男性和/或年龄<65 岁的患者中降低(在男性患者中,第 1 年和第 5 年分别为 p = 0.047 和 p = 0.020;在年龄<65 岁的患者中,第 1 年和第 5 年分别为 p = 0.028 和 p = 0.006;在年龄<65 岁的男性患者中,第 1 年和第 5 年分别为 p = 0.039 和 p = 0.032)。与未根除组相比,H. pylori 的根除与整个随访期间 A1C 值的降低相关(p = 0.017)。

结论

在长期随访中,H. pylori 的根除与 T2DM 或 preDM 患者的 A1C 水平降低有关,尤其是在男性和年龄<65 岁的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc53/9082431/6e142357b453/kjim-2021-194f1.jpg

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