Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
PLoS One. 2022 May 23;17(5):e0265323. doi: 10.1371/journal.pone.0265323. eCollection 2022.
Helicobacter pylori infection is known to decrease the incidences of autoimmune diseases and inflammatory bowel disease(IBD). Our aim was investigating the effect of H. pylori treatment in diabetes mellitus(DM) patients.
Adults with newly-diagnosed H. pylori infection or peptic ulcer disease(PUD) within the general population and DM population were identified from the National Health Insurance Research Database of Taiwan from 2000-2010. 79,181 patients were assigned to the 3 groups: general population with PUD without H. pylori treatment(PUD-HPRx in general population), DM patients with PUD without H. pylori treatment(PUD-HPRx in DM), and DM patients with PUD who received H. pylori treatment(PUD+HPRx in DM).
Higher incidences of autoimmune diseases and IBD were observed in the PUD+HPRx in DM group than in the PUD-HPRx in general population and PUD-HPRx in DM groups (autoimmune diseases = 5.14% vs 3.47% and 3.65%; IBD = 5.60% vs 3.17% and 3.25%; P<0.0001). A lower all-cause mortality was noted in the PUD+HPRx in DM group (HR: 0.937, P<0.001) than in the PUD-HPRx in DM group. Trends of a higher incidence of IBD and a lower mortality in younger patients in the PUD+HPRx in DM group compared with the PUD-HPRx in DM group were noted.
The results revealed that H. pylori treatment increased the incidences of autoimmune diseases and IBD and decreased the all-cause mortality in the DM group with PUD. The effect was more significant in younger patients. This finding assists in realizing the influence of H. pylori treatment in the DM population.
已知幽门螺杆菌（H. pylori）感染可降低自身免疫性疾病和炎症性肠病（IBD）的发生率。我们的目的是研究 H. pylori 治疗对糖尿病（DM）患者的影响。
从台湾全民健康保险研究数据库中，我们在一般人群和 DM 人群中确定了 2000-2010 年内新诊断的 H. pylori 感染或消化性溃疡病（PUD）的成年人。将 79181 名患者分为 3 组：一般人群中未接受 H. pylori 治疗的 PUD（一般人群中未治疗的 PUD-HPRx，PUD-HPRx in general population）、DM 患者中未接受 H. pylori 治疗的 PUD（DM 患者中未治疗的 PUD-HPRx，PUD-HPRx in DM）和 DM 患者中接受 H. pylori 治疗的 PUD（DM 患者中接受 H. pylori 治疗的 PUD-HPRx，PUD+HPRx in DM）。
与 PUD-HPRx in general population 和 PUD-HPRx in DM 组相比，PUD+HPRx in DM 组中自身免疫性疾病和 IBD 的发生率更高（自身免疫性疾病=5.14%比 3.47%和 3.65%；IBD=5.60%比 3.17%和 3.25%；P<0.0001）。与 PUD-HPRx in DM 组相比，PUD+HPRx in DM 组的全因死亡率更低（HR：0.937，P<0.001）。与 PUD-HPRx in DM 组相比，PUD+HPRx in DM 组年轻患者中 IBD 发生率更高和死亡率更低的趋势更为明显。
结果表明，在患有 PUD 的 DM 组中，H. pylori 治疗增加了自身免疫性疾病和 IBD 的发生率，并降低了全因死亡率。在年轻患者中效果更为显著。这一发现有助于认识 H. pylori 治疗对 DM 人群的影响。
