Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. Faculty of Life Sciences and Medicine, Northwest University, Guangming Road, Shenmu, China.
Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China.
BMJ Open. 2024 Nov 2;14(11):e080980. doi: 10.1136/bmjopen-2023-080980.
is a type of Gram-negative microaerobic bacteria that inhabits the gastric mucosal epithelium. It can cause various gastrointestinal diseases including gastritis, peptic ulcer and gastric cancer. White blood cells (WBC) are common immune cells, the increase in whose countoften indicates the presence of an infection. Currently, the relationship between and WBC count remains full of controversy. This study aims to further elucidate the effects of on WBC count in a population undergoing physical examination.
A total of 864 participants who underwent physical examination and C urea breath test (UBT) were retrospectively enrolled in this study from January to June 2021. The overall population was divided into -negative (Hp-) and -positive (Hp+) groups based on the disintegration per minute (DPM) value detected by UBT. Spearman's correlation analysis was used to assess the correlation between DPM and WBC count. General linear regression models were applied to assess the potential factors contributing to the increase in WBC count. Generalised additive model (GAM) was performed to identify the non-linear relationship between DPM and WBC count. Additionally, a piecewise linear regression was used to examine the threshold effect of the DPM on WBC count.
403 subjects were diagnosed with infection. The WBC and platelet (PLT) counts in the Hp+ group were significantly higher than those in the Hp- group. Additionally, the prevalence of infection gradually increased with the WBC count quartiles (38.89% and 54.67% in quartile 1 and quartile 4, respectively). Spearman's correlation analysis showed that the DPM value significantly correlated with WBC count (r=0.089, p=0.009) and PLT count (r=0.082, p=0.017). The linear model revealed a positive independent association of infection and DPM with WBC count (β=0.398 (95% CI 0.170, 0.625), p<0.001; β=0.002 (95% CI 0.000, 0.0030), p=0.018). The results of the GAM and the piecewise linear regression suggested that the cut-off points of the association between DPM and WBC count were 40 and 155 of DPM, that is, the effect of DPM on WBC count varied with the difference of DPM <40, 40-155, and >155 (β=-0.005 (95% CI -0.017, 0.007), p=0.423; β=0.006 (95% CI 0.002, 0.013), p=0.047; and β=-0.007 (95% CI -0.012, -0.002), p=0.004, respectively).
infection was independently and positively correlated with WBC count; however, the effect of DPM on WBC count varied across different WBC count intervals, suggesting distinct immunological responses at different stages of infection.
是一种革兰氏阴性微需氧细菌，栖息在胃黏膜上皮细胞中。它可以引起各种胃肠道疾病，包括胃炎、消化性溃疡和胃癌。白细胞（WBC）是常见的免疫细胞，其计数的增加通常表明存在感染。目前，与之间的关系仍然充满争议。本研究旨在进一步阐明在接受体检的人群中对 WBC 计数的影响。
本研究回顾性纳入了 2021 年 1 月至 6 月期间接受体检和 C 尿素呼气试验（UBT）的 864 名参与者。根据 UBT 检测到的每分钟分解数（DPM）值，将总体人群分为阴性（Hp-）和阳性（Hp+）组。采用 Spearman 相关分析评估 DPM 与 WBC 计数之间的相关性。应用广义线性回归模型评估导致 WBC 计数增加的潜在因素。应用广义加性模型（GAM）确定 DPM 与 WBC 计数之间的非线性关系。此外，使用分段线性回归来检查 DPM 对 WBC 计数的阈值效应。
403 名受试者被诊断为感染。Hp+组的 WBC 和血小板（PLT）计数明显高于 Hp-组。此外，感染的患病率随着 WBC 计数四分位的增加而逐渐增加（第 1 四分位和第 4 四分位分别为 38.89%和 54.67%）。Spearman 相关分析显示，DPM 值与 WBC 计数（r=0.089，p=0.009）和 PLT 计数（r=0.082，p=0.017）显著相关。线性模型显示感染和 DPM 与 WBC 计数呈正相关（β=0.398（95%CI 0.170，0.625），p<0.001；β=0.002（95%CI 0.000，0.0030），p=0.018）。GAM 和分段线性回归的结果表明，DPM 与 WBC 计数之间关联的截断点为 DPM 的 40 和 155，即 DPM 对 WBC 计数的影响因 DPM<40、40-155 和>155 而有所不同（β=-0.005（95%CI -0.017，0.007），p=0.423；β=0.006（95%CI 0.002，0.013），p=0.047；β=-0.007（95%CI -0.012，-0.002），p=0.004）。
感染与 WBC 计数独立且呈正相关；然而，DPM 对 WBC 计数的影响因不同的 WBC 计数区间而有所不同，这表明在感染的不同阶段存在不同的免疫反应。
