Department of Hospital infection management, LinYi people's Hospital, LinYi, Shandong Province, China.
Graduate School of Hainan Medical University, Haikou, China.
BMC Infect Dis. 2024 Mar 12;24(1):305. doi: 10.1186/s12879-024-09196-1.
There is controversy concerning the relationship between Helicobacter pylori (H. pylori) infection and osteoporosis. This study is to examine the causal relationship between H. pylori infection and osteoporosis and to analyze the potential mechanism underlying the relationship.
The clinical data of H. pylori infection and bone mineral density from patients or physical examiner with good general condition in our hospital between September 2019 and September 2020 were retrospectively collected. The relationship between H. pylori infection and osteoporosis was compared and analyzed, using logistic regression to examine the potential mechanism underlying the association. To investigate the causal effects of H. pylori infection and osteoporosis, we conducted a two-sample bidirectional Mendelian randomization (MR) analysis.
A total of 470 patients were positive for H. pylori, with a detection rate of 52.22%. It was found that age, SBP, FPG, DBP, ALB, LDL-C, hs-CRP, and OC were positively correlated with osteoporosis, while negative correlations were observed with BMI, LYM, ALB, TP, TG, HDL-C, SCr, UA, and VitD. After stratified analysis of sex and age, it was found that there was a significant correlation between H. pylori infection and osteoporosis. The levels of SBP, ALP, FPG, LDL-C, hs-CRP, and OC in both H. pylori-positive group and osteoporosis group were higher than those in the H. pylori-negative group while the levels of BMI, ALB, TP, HDL-C, SCr, UA, and VitD in the positive group were significantly lower than those in the negative group. Logistic regression analyses with gender and age showed that ALB, FPG, HDL-C, and VitD were common risk factors for osteoporosis and H. pylori infection. In the MR analysis, the IVW results found a positive effect of H. pylori infection on osteoporosis (OR = 1.0017, 95% CI: 1.0002-1.0033, P = 0.0217). Regarding the reverse direction analysis, there was insufficient evidence to prove the causal effects of osteoporosis on H. pylori infection.
Our study provides evidence for causal effects of H. pylori infection on osteoporosis. H. pylori may affect osteoporosis through serum albumin, high-density lipoprotein, fasting blood glucose and vitamin D.
幽门螺杆菌（H. pylori）感染与骨质疏松症之间的关系存在争议。本研究旨在探讨 H. pylori 感染与骨质疏松症之间的因果关系，并分析其潜在的关系机制。
回顾性收集 2019 年 9 月至 2020 年 9 月期间我院一般情况良好的 H. pylori 感染患者或体检者的临床资料，包括 H. pylori 感染和骨密度。比较分析 H. pylori 感染与骨质疏松症的关系，采用 logistic 回归检验关联的潜在机制。为了探讨 H. pylori 感染和骨质疏松症的因果效应，我们进行了两样本双向 Mendelian 随机化（MR）分析。
共 470 例患者 H. pylori 阳性，检出率为 52.22%。结果发现，年龄、SBP、FPG、DBP、ALB、LDL-C、hs-CRP 和 OC 与骨质疏松症呈正相关，而 BMI、LYM、ALB、TP、TG、HDL-C、SCr、UA 和 VitD 与骨质疏松症呈负相关。对性别和年龄进行分层分析后发现，H. pylori 感染与骨质疏松症之间存在显著相关性。H. pylori 阳性组和骨质疏松症组的 SBP、ALP、FPG、LDL-C、hs-CRP 和 OC 水平均高于 H. pylori 阴性组，而 H. pylori 阳性组的 BMI、ALB、TP、HDL-C、SCr、UA 和 VitD 水平明显低于 H. pylori 阴性组。性别和年龄的 logistic 回归分析显示，ALB、FPG、HDL-C 和 VitD 是骨质疏松症和 H. pylori 感染的共同危险因素。在 MR 分析中，IVW 结果发现 H. pylori 感染对骨质疏松症有正向影响（OR=1.0017，95%CI：1.0002-1.0033，P=0.0217）。对于反向分析，没有足够的证据证明骨质疏松症对 H. pylori 感染的因果效应。
本研究为 H. pylori 感染与骨质疏松症之间的因果关系提供了证据。H. pylori 可能通过血清白蛋白、高密度脂蛋白、空腹血糖和维生素 D 影响骨质疏松症。
