de Luis D A, Lahera M, Cantón R, Boixeda D, San Román A L, Aller R, de La Calle H
Department of Endocrinology, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
Diabetes Care. 1998 Jul;21(7):1129-32. doi: 10.2337/diacare.21.7.1129.
Infection by Helicobacter pylori has been epidemiologically linked to some extradigestive conditions, including ischemic heart disease. Diabetic patients are an at-risk population for cardiovascular and thrombo-occlusive cerebral disease. The aim of the study was to examine a possible relationship between H. pylori infection and cardiovascular or cerebrovascular disease in diabetic patients.
This was a cross-sectional case-control study with 127 diabetic patients (both IDDM and NIDDM). Special emphasis was placed on the detection of clinical macro- and microvascular complications, cardiovascular risk factors, acute phase reactants, and serological markers of increased cardiovascular disease risk. H. pylori infection was assessed through the determination of specific Ig-G titers, measured by a commercial enzyme-linked immunosorbent assay.
Coronary heart disease was more prevalent in diabetic patients with than without H. pylori (odds ratio [OR] 4.07; 95% CI 1.21-13.6; P < 0.05). A history of thrombo-occlusive cerebral disease was also more frequent in H. pylori-positive diabetic patients (OR 4.8; 95% CI 1.24-18.51; P < 0.05). Other complications such as peripheral arteriopathy, advanced nephropathy, neuropathy, or retinopathy were no differently distributed according to serological status. Alterations in the levels of the following acute-phase reactants and blood chemistry determinations were significantly more profound in H. pylori-positive diabetic patients: high fibrinogen (P < 0.05), high erythrocyte sedimentation rate (P < 0.001), high triglycerides (P < 0.001), and low HDL cholesterol (P < 0.001). There values were also more deeply altered in H. pylori-positive diabetic patients with a history of coronary heart disease, thrombo-occlusive cerebral disease, or both, when compared with H. pylori-positive diabetic patients without those complications.
Our data indicate a possible association of H. pylori infection and the development of coronary heart disease, thrombo-occlusive cerebral disease, or both, in diabetic patients. The importance of this link is highlighted by the possibility of an effective intervention against H. pylori infection.
幽门螺杆菌感染在流行病学上与一些消化系统外疾病有关，包括缺血性心脏病。糖尿病患者是心血管和血栓闭塞性脑血管疾病的高危人群。本研究的目的是探讨幽门螺杆菌感染与糖尿病患者心血管或脑血管疾病之间可能存在的关系。
这是一项横断面病例对照研究，纳入了127例糖尿病患者（包括胰岛素依赖型糖尿病和非胰岛素依赖型糖尿病）。特别着重于检测临床大血管和微血管并发症、心血管危险因素、急性期反应物以及心血管疾病风险增加的血清学标志物。通过使用商业酶联免疫吸附测定法测定特异性Ig-G滴度来评估幽门螺杆菌感染情况。
幽门螺杆菌感染的糖尿病患者中冠心病更为普遍（比值比[OR] 4.07；95%可信区间1.21 - 13.6；P < 0.05）。血栓闭塞性脑血管疾病史在幽门螺杆菌阳性的糖尿病患者中也更为常见（OR 4.8；95%可信区间1.24 - 18.51；P < 0.05）。其他并发症，如外周动脉病、晚期肾病、神经病变或视网膜病变，根据血清学状态分布无差异。以下急性期反应物水平和血液化学测定结果的改变在幽门螺杆菌阳性的糖尿病患者中明显更为显著：高纤维蛋白原（P < 0.05）、高红细胞沉降率（P < 0.001）、高甘油三酯（P < 0.001）和低高密度脂蛋白胆固醇（P < 0.001）。与没有这些并发症的幽门螺杆菌阳性糖尿病患者相比，有冠心病、血栓闭塞性脑血管疾病或两者病史的幽门螺杆菌阳性糖尿病患者这些数值的改变也更为明显。
我们的数据表明幽门螺杆菌感染与糖尿病患者冠心病、血栓闭塞性脑血管疾病或两者的发生可能存在关联。针对幽门螺杆菌感染进行有效干预的可能性凸显了这种关联的重要性。
