The relationship between body-mass index and Helicobacter pylori infection: a case-control study

Abstract

Objective: Helicobacter pylori infection is one of the most common infections worldwide. There are different opinions in the literature about the relationship between H. pylori and obesity. In this study, we investigated the relationship between body-mass index (BMI) and H. pylori infection. Material and methods: A cross-sectional study was conducted among patients who underwent endoscopic examinations at Tekirdağ University Faculty of Medicine Hospital in 2019. The prevalence of H. pylori infection was examined by biopsy. The relationship between BMI and H. pylori infection was analyzed. Results: 51.8% of the cases in our population were positive for H. pylori infection. On histopathological examination, acute and chronic inflammation findings were higher in H. pylori-positive cases compared to H. pylori-negative cases. The prevalence of H. pylori infection was higher in patients with high BMI than those with low BMI. Statistical analysis showed a significant relationship between BMI and the prevalence of H. pylori infection (p < 0.001), and there was a positive linear correlation between these two parameters (r=0.542). When the risk factors were examined univariable, BMI was found to be a significant risk factor for H. pylori infection (p = 0.008). Multivariable analysis results revealed that BMI is an independent risk factor for H. pylori infection. (OR = 1.32 [1.09-3.46], p = 0.025). Conclusions: Our results showed that there is a significant relationship between BMI and H. pylori infection, and high BMI is an independent risk factor for H. pylori infection.

Keywords

• Body-mass index
• gastritis
• Helicobacter pylori
• histopathological findings

Vücut-kitle indeksi ile Helicobacter pylori enfeksiyonu arasındaki ilişki: bir vaka kontrol çalışması

Abstract

Amaç: Helicobacter pilori enfeksiyonu tüm dünya genelinde oldukça yaygın olan enfeksyonlardan biridir. H. pylori ile obezite arasındaki ilişki hakkında literatürde farklı görüşler vardır. Bu çalışmada vücut-kitle indeksi (VKİ) ile H. pylori enfeksiyonu arasındaki ilişkiyi araştırdık. Gereç ve yöntemler: 2019 yılı içerisinde Tekirdağ Üniversitesi Tıp Fakültesi Hastanesinde endoskopik muayeneleri yapılan hastalar arasında kesitsel bir çalışma yapıldı. H. pylori enfeksiyonunun prevalansı biyopsi ile incelendi. VKİ ile H. pylori enfeksiyonu arasındaki ilişki analiz edildi. Bulgular: Popülasyonumuzdaki olguların % 51.8 'i H. pylori enfeksiyonu açısından pozitifti. Histopatolojik incelemede H. pylori-pozitif olgularda akut ve kronik inflamasyon bulguları H. pylori-negatif olgulara kıyasla daha fazla idi. VKİ’si yüksek olan hastalarda H. pylori enfeksiyonu prevalansı VKİ’si düşük olanlara göre daha fazla idi. İstatiistksel analizde VKİ ile H. pylori enfeksiyonu prevalansı arasında anlamlı bir ilişki olduğu görüldü (p < 0.001) ve bu iki parametre arasında pozitif bir doğrusal korelasyon vardı (r = 0.542). Risk faktörleri tek değişkenli olarak incelendiğinde VKİ’nin H. pylori enfeksiyonu açısından anlamlı bir risk faktörü olduğu tespit edildi (p = 0.008). Çoklu analiz sonuçları ise VKİ'nin H. pylori enfeksiyonu açısında bağımsız bir risk faktörü olduğunu ortaya koydu (OR=1.32 [1.09-3.46], p=0.025). Sonuçlar: Bulgularımız VKİ ile H. pylori enfeksiyonu arasında anlamlı bir ilişkili olduğunu ve yüksek VKİ'nin H. pylori enfeksiyonu açısından bağımsız bir risk faktörü olduğunu gösterdi.

Keywords

• Vücut-kitle indeksi
• gastrit
• Helicobacter pylori
• hitopatolojik bulgular

References

1. Lorenzo I, Fernández-de-Larrea N, Michel A, et al. Helicobacter pylori seroprevalence in Spain: influence of adult and childhood sociodemographic factors. Eur J Cancer Prev 2019; 28: 294-303.
2. Krueger WS, Hilborn ED, Converse RR, Wade TJ. Environmental risk factors associated with Helicobacter pylori seroprevalence in the United States: a cross-sectional analysis of NHANES data. Epidemiol Infect 2015; 143: 2520-31.
3. Bastos J, Carreira H, La Vecchia C, et al. Childcare attendance and Helicobacter pylori infection: systematic review and meta-analysis. Eur J Cancer Prev 2013; 22: 311–9.
4. Caballero B. Humans against Obesity: Who Will Win? Adv Nutr 2019; 10: S4-S9.
5. Albuquerque D, Nóbrega C, Manco L, et al. The contribution of genetics and environment to obesity. Br Med Bull 2017; 123: 159-73.
6. Zhang Y, Du T, Chen X, et al. Association between Helicobacter pylori infection and overweight or obesity in a Chinese population. J Infect Dev Ctries 2015; 9: 945–53.
7. Siddiqui B, Yakoob J, Abbas Z, et al. Distribution of Helicobacter pylori infection and abnormal body- mass index (BMI) in a developing country. J Infect Dev Ctries 2018; 12: 342-6.
8. Suki M, Leibovici Weissman Y, Boltin D, et al. Helicobacter pylori infection is positively associated with an increased BMI, irrespective of socioeconomic status and other confounders: a cohort study. Eur J Gastroenterol Hepatol 2018; 30: 143-8.

9. Hamada M, Nomura R, Ogaya Y, et al. Potential involvement of Helicobacter pylori from oral specimens in overweight body-mass index. Sci Rep 2019; 9: 4845.
10. Kamboj AK, Cotter TG, Oxentenko AS. Helicobacter pylori: The past, present, and future in management. Mayo Clin Proc 2017; 92: 599-604.
11. Mentis A, Lehours P, Mégraud F. Epidemiology and Diagnosis of Helicobacter pylori infection. Helicobacter 2015; 20: 1-7.
12. Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter 2014; 19: 1-5
13. Mitchell H, Katelaris P. Epidemiology, clinical impacts and current clinical management of Helicobacter pylori infection. Med J Aust 2016; 204: 376‐ 80.
14. Peng C, Li NS, Hu Y, Lu NH. Impact factors that modulate gastric cancer risk in Helicobacter pylori-infected rodent models. Helicobacter 2019; 24: e12580.
15. Munoz‐Ramirez ZY, Mendez‐Tenorio A, Kato I, et al. Whole genome sequence and phylogenetic analysis show Helicobacter pylori strains from Latin America have followed a unique evolution pathway. Front Cell Infect Microbiol 2017; 7: 50
16. Polyzos SA, Kountouras J, Zavos C, et al. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter 2011; 16: 79–88.
17. Renshaw AA, Rabaza JR, Gonzalez AM, et al. Helicobacter pylori infection in patients undergoing gastric bypass surgery for morbid obesity. Obes Surg 2001; 11: 281–3.
18. Arslan E, Atilgan H, Yavasoglu I. The prevalence of Helicobacter pylori in obese subjects. Eur J Intern Med 2009; 20: 695–7.
19. Lane JA, Murray LJ, Harvey IM, et al. Randomised clinical trial: Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo‐controlled study. Aliment Pharmacol Ther 2011; 33: 922–9.
20. Yang YJ, Sheu BS, Chang WL, et al. Increased body mass index after H. pylori eradication for duodenal ulcer predisposes to erosive reflux esophagitis. J Clin Gastroenterol 2009; 43: 705–10.
21. Marti A, Marcos A, Martinez JA. Obesity and immune function relationships. Obes Rev 2001; 2: 131–40.
22. Moulin CM, Marguti I, Peron JP, et al. Impact of adiposity on immunological parameters. Arq Bras Endocrinol Metabol 2009; 53: 183–9.
23. Krishnan EC, Trost L, Aarons S, et al. Study of function and maturation of monocytes in morbidly obese individuals. J Surg Res. 1982; 33: 89–97.
24. Perdichizzi G, Bottari M, Pallio S, et al. Gastric infection by Helicobacter pylori and antral gastritis in hyperglycemic obese and in diabetic subjects. New Microbiol. 1996; 19: 149-54.
25. Glass CK, Olefsky JM. Inflammation and lipid signaling in the etiology of insulin resistance. Cell Metab 2012; 15: 635–45.
26. Basso D, Plebani M, Kusters JG. Pathogenesis of Helicobacter pylori infection. Helicobacter 2010; 15: 14–20.
27. Osawa H, Nakazato M, Date Y, et al. Impaired production of gastric ghrelin in chronic gastritis associated with Helicobacter pylori. J Clin Endocrinol Metab 2005; 90: 10–6.
28. Furuta T, Shirai N, Xiao F, et al. Effect of Helicobacter pylori infection and its eradication on nutrition. Aliment Pharmacol Ther 2002; 16799- 806.
29. Roper J, Francois F, Shue PL, et al. Leptin and ghrelin in relation to Helicobacter pylori status in adult males. J Clin Endocrinol Metab 2008; 93: 2350–7.
30. Kawano S, Kawahara A, Nakai R, et al. Helicobacter pylori infection does not affect serum leptin concentration and body mass index. J Gastroenterol 2001; 36579-580.
31. Blaser MJ, Atherton JC. Helicobacter pylori persistence: biology and disease. J Clin Invest 2004; 113: 321-3.