Başpinar Osman, Elibol Ayça, Koçer Derya, Tokmak Turgut Tursem, Doğan Serkan, Dizdar Oğuzhan Sıtkı
Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey.
Department of Medical Biochemistry, Kayseri City Training and Research Hospital, Kayseri, Turkey.
Clin Investig Arterioscler. 2024 Mar-Apr;36(2):51-59. doi: 10.1016/j.arteri.2023.09.002. Epub 2023 Oct 17.
The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with Helicobacter pylori (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels.
This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c).
The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (p≤0.001). There was a significant correlation between serum GDF-15 level and CIMT (r=0.445; p≤0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (p<0.001). Vitamin B12 and D levels were comparable among groups.
This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.
本研究旨在通过测量幽门螺杆菌(HP)感染患者的颈动脉内膜中层厚度(CIMT)来调查亚临床动脉粥样硬化的存在情况,并通过评估动脉粥样硬化标志物和血液生长分化因子(GDF-15)水平来评估HP对动脉粥样硬化的影响。
这项横断面研究纳入了59例在上消化道内镜活检中无合并症的HP感染患者以及30例无HP感染的健康对照者。为了评估动脉粥样硬化,通过超声检查测量CIMT。采用酶联免疫吸附测定法(ELISA)测量血清GDF-15水平。记录所有患者的动脉粥样硬化标志物。计算致动脉粥样硬化指数,包括卡斯泰利风险指数I和II(分别为TG/HDL-c和LDL-c/HDL-c)、血浆致动脉粥样硬化指数(PAI;log TG/HDL-c)、非HDL-c(TH-HDL-c)和致动脉粥样硬化系数(AC;非HDL-HDL-c)。
与HP阴性组相比,HP阳性组的GDF-15水平和CIMT显著更高(p≤0.001)。血清GDF-15水平与CIMT之间存在显著相关性(r=0.445;p≤0.001)。其他动脉粥样硬化标志物与血清GDF-15水平或CIMT之间无相关性。内镜标本上的细菌强度仅与CIMT相关(p<0.001)。各组间维生素B12和D水平相当。
本研究表明,HP感染患者的GDF-15水平与亚临床动脉粥样硬化的发展之间存在相关性。然而,在致动脉粥样硬化指数正常的情况下发现GDF-15水平升高,它可能是亚临床动脉粥样硬化的一个早期标志物。