Gasbarrini A, Ojetti V, Pitocco D, De Luca A, Franceschi F, Candelli M, Sanz Torre E, Pola P, Ghirlanda G, Gasbarrini G
Medical Pathology, Catholic University of Rome, Italy.
Eur J Gastroenterol Hepatol. 1998 Jun;10(6):469-72. doi: 10.1097/00042737-199806000-00006.
BACKGROUND/AIM: Insulin-dependent diabetes mellitus (IDDM) is the result of an autoimmune destruction of pancreatic Langerhans beta cells. Helicobacter pylori infection, the most common cause of gastritis and peptic ulcer, has been associated with some autoimmune diseases. The aim of this study was to evaluate the prevalence of H. pylori infection and gastrointestinal (GI) symptoms in patients with IDDM.
116 patients (50 males and 66 females, mean age: 35 +/- 11 years) affected by IDDM were evaluated; 50 healthy subjects matched for age and sex were utilized as a control group. H. pylori infection was determined by a [13C]urea breath test. IDDM duration, daily dosage of insulin and prevalence of GI symptoms (bloating, pyrosis, epigastric pain, belching, halitosis, nausea) were assessed.
The prevalence of H. pylori infection was similar in IDDM patients and in controls (37 vs 34%, respectively). In both groups, the mean age was higher in infected subjects. The mean IDDM duration was significantly greater in infected patients (19 +/- 12 vs 13 +/- 10 years, P < 0.006). Prevalence of infection was directly related to the duration of IDDM (<1 year, 23%; 1-3 years, 32%; >3 years, 40%). The daily dosage of insulin did not differ between infected and non-infected subjects. H. pylori contaminated patients showed a significantly higher prevalence of bloating, pyrosis and epigastric pain when compared with non-infected subjects; conversely, prevalence of belching, halitosis and nausea did not differ between groups.
The prevalence of H. pylori infection is high in patients affected by IDDM; however, it does not differ from the infection rate observed in a control group. The rate of infection increases with IDDM duration. Bloating, pyrosis and epigastric pain appear to define infection status better.
背景/目的：胰岛素依赖型糖尿病（IDDM）是胰腺朗格汉斯β细胞发生自身免疫性破坏的结果。幽门螺杆菌感染是胃炎和消化性溃疡最常见的病因，它与一些自身免疫性疾病有关。本研究的目的是评估IDDM患者中幽门螺杆菌感染率及胃肠道（GI）症状。
对116例IDDM患者（50例男性和66例女性，平均年龄：35±11岁）进行评估；选取50名年龄和性别匹配的健康受试者作为对照组。采用[13C]尿素呼气试验测定幽门螺杆菌感染情况。评估IDDM病程、胰岛素每日剂量及GI症状（腹胀、烧心、上腹部疼痛、嗳气、口臭、恶心）的发生率。
IDDM患者和对照组的幽门螺杆菌感染率相似（分别为37%和34%）。在两组中，感染受试者的平均年龄均较高。感染患者的IDDM平均病程显著更长（19±12年 vs 13±10年，P<0.006）。感染率与IDDM病程直接相关（<1年，23%；1 - 3年，32%；>3年，40%）。感染和未感染受试者的胰岛素每日剂量无差异。与未感染受试者相比，幽门螺杆菌感染患者的腹胀、烧心和上腹部疼痛发生率显著更高；相反，两组间嗳气、口臭和恶心的发生率无差异。
IDDM患者中幽门螺杆菌感染率较高；然而，与对照组观察到的感染率无差异。感染率随IDDM病程增加。腹胀、烧心和上腹部疼痛似乎能更好地确定感染状态。
