Incidence of Helicobacter pylori Seropositivity in Turkish Pregnant Women with Gestational Diabetus Mellitus

Öz

Aim: The aim of this study to determine the Helicobacter pylori (HP) seropositivity in pregnant Turkish women and investigate the relationship with Gestational Diabetus Mellitus (GDM) with HP. 

Material and Methods: A prospective case control study was conducted between September and November 2019 at Zonguldak Bulent Ecevit University, School of Medicine, Obstetrics and Gynecology Department. Pregnant women who were 18-40 years old, at 26-37 weeks of gestational age and had singleton pregnancies included. Exclusion criteria were: Multiple pregnancy, pre-gestational diabetes mellitus, hypertension, hyperlipidemia, anemia and other systemic diseases. Study group was consisted of 46 women with diagnosed as GDM due to 75 gr oral glucose test and control group was consisted of 28 women. HP IgA ve IgG antibodies were measured using ELISA. Women were considered as HP (+) when IgA and/or IgG antibodies were positive, and considered as HP (-)  when both antibodies were negative.

Results: No difference were seen in maternal age, gravidity, parity, abortus, gestational age, ultrasonographic age, and estimated fetal weight between two groups. Body mass index, fasting blood glucose and fasting insulin levels, and HOMA-IR were significantly higher in GDM group than control group (p=0.018; p=<0.001; p=0.004; p=0.001 respectively).  HP seropositivity were 77.3% in GDM group and 66.7% in control group but this difference was not statistically significant. HP IgG seropositivity was significantly higher in GDM group than control group (65.9% vs 31.8%, p=0,010). On the other hand HP IgA incidence was not different between two groups. Presence of both HP IgG and IgA seropositivity was higher in GDM group (28.2% vs 10.71%, GDM and control groups respectively, p= 0.008).   

Conclusion: Incidence of HP seropositivity and HP IgG seropositivity in Turkish pregnant women with GDM were higher than pregnant women without GDM, but statistical significance could not be established in aspect of HP seropositivity. This data will be helpful for future studies that will investigate relation between HP seropositivity and pregnancy complications. 

Anahtar Kelimeler

• Pregnancy,Helicobacter pylori,Gestational diabetes mellitus

Türk Toplumundaki Gestasyonel Diabetes Mellitus’lu Gebelerde Helicobacter pylori Seropozitivitesi Insidansı

Öz

Amaç: Bu çalışmanın amacı Türk toplumundaki gebe kadınlarında Helicobacter pylori (HP) seropozitivitesinin GDM ile ilişkisini araştırmaktır. 

Gereç ve Yöntemler: Eylül 2019- Kasım 2019 tarihleri arasında, Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum AD’na başvuran 18-40 yaş arası, 26-37 haftalar arasında tekil gebeliği bulunan gebeler çalışmaya dahil edildi. Çoğul gebelikler, gebelik öncesi diyabet, hipertansiyon, hiperlipidemi, anemi ve ek sistemik hastalığı bulunan gebeler dışlandı. GDM tanısı almış 46 gebe GDM Grubu, diğer 28 gebe kontrol grubu olarak ayrıldı. Gebelerde HP IgA ve IgG antikorları ELISA yöntemi ile çalışıldı. IgA ve IgG antikorlarından herhangi biri pozitif olan hastalar HP(+), IgA ve IgG antikorlarından her ikisi de negatif olan hastalar HP(-) kabul edildi. 

Bulgular: Yaş, gravida, parite, abortus, gestasyonel yaş, ultrasonografik yaş, ve tahmini fetal ağırlık her iki grupta da benzerdi. VKİ, AKŞ, açlık insülin ve HOMA-IR değerleri GDM grubunda kontrol grubuna göre anlamlı olarak yüksekti (sırasıyla p=0,018; p=<0,001; p=0,004; p=0,001). GDM grubunda gebelerin %77,3’ü, kontrol grubundaki gebelerin ise %66,7’si HP (+)  olarak saptandı fakat istatistiksel olarak fark bulunamadı. GDM grubunda HP IgG %65,9 oranında pozitif iken, kontrol grubunda ise %31,8 olarak saptandı (p=0,010). Diğer taraftan HP IgA insidansı açısından iki grup arasında fark gözlenmedi (p=0,563). Her iki HP antikorunun da pozitif saptandığı gebelerin oranın ise GDM grubunda kontrol grubuna göre daha yüksek olduğu görüldü (%28,2 vs %10,71, p= 0,008).  

Sonuç: Türk toplumundaki GDM’li gebelerde HP seropozitivitesi insidansı GDM bulunmayan gebelerden yüksek olsa da istatistiksel olarak benzerdir. HP IgG seropozitivitesi ise GDM grubunda daha yüksek bulunmuştur. Bu bulgular Türk toplumundaki gebe kadınlarda HP enfeksiyonu ve gebelik komplikasyonlarının araştırılması açısından da faydalı olacaktır. 

Anahtar Kelimeler

• Gestasyonel diabetes mellitus,Gebelik,Helicobacter pylori

Kaynakça

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