Prevalence

Figure 1 shows the prevalence of infection with H. pylori by age in American men aged 40-74. The prevalence generally rose in each decade of life from the fifth through seventh decades.

Myocardial Infarction

Age-specific exposure prevalence by MI history is shown in Table 1. At age 40-74 combined, among 118 men with a history of doctor-diagnosed MI prevalence of H. pylori infection was no greater than in 1,483 men with no such history (age-adjusted OR=1.07, 95% CI 0.60-1.90). Similarly, in 39 men with a history of doctor-diagnosed stroke and in 1,588 men with no such history, prevalence of infection did not differ (age-adjusted OR=0.98, 95% CI 0.51-1.89). Thus, no overall association was evident in men without a history of diabetes.

Figure 1. Age-specific Helicobacter

Figure 1. Age-specific Helicobacter pylori seroprevalence (percent) in American men aged 40-74 years in the Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES IH).

However, in the subgroup of 183 diabetic men, infection was significantly associated with a history of MI (n=33, age-, ethnicity-adjusted OR=5.56, 95% CI 1.28-24.12, p=0.024). Too few prevalent stroke cases (n=13) were reported for analysis in the diabetic subgroup. eriacta

Noninsulin-Dependent Diabetes

In men aged 40-74, 52.7% (n=193) of men with a history of doctor-diagnosed and 38.6% (n=1,628) of men with no such history had evidence of H. pylori infection. In logistic regression models, the positive relationship between H. pylori infection (yes, no) and diabetic status (dependent variable) after adjusting for age or age and race/ethnicity did not attain statistical significance (age-adjusted OR 1.47, 95% CI 0.92-2.36, p=0.10).

Table 1. Prevalence (Percent) of H. pylori Seropositive by History of Myocardial Infarction and Age in Diabetic Men: Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III)

Ml History
Age (Years) Negative Positive
40-59 40.1 68.8
60-69 45.0 96.0
70-74 45.9 83.5
N 154 33

In all men aged 40-74, infection status was not significantly associated with glycated hemoglobin (HbAic) concentration (%) (age-, ethnicity-adjusted beta -0.11, se 0.08, p=0.21). Nor was there a significant association between infection and HbAic in men with a history of diabetes (age-, ethnicity-adjusted beta -0.19, se 0.49, p=0.69), or in those without such a history (age-, ethnicity-adjusted beta -0.05, se 0.05, P=0.33).

Inflammation

In American men aged 40-74 after adjusting for age and ethnicity, infection with H. pylori was not significantly associated with serum C-reactive protein concentration (p=0.31), white blood cell count (p=0.14), or plasma fibrinogen concentration (p=0.74), markers of inflammation. However, a positive association of infection with serum ferritin concentration was seen (beta 28.20, 11.87, p=0.03). In those with and without infection, age-, ethnicity-adjusted means were CRP 0.42 versus 0.37 mg/dL, white blood cell count 7.49 versus 7.17 x 103 cell/mm3, plasma fibrinogen 294 versus 299 mg/dL, respectively. Serum ferritin was significantly higher in those with infection (mean 200 versus 178 ng/dL).

Table 2. Linear Regression Coefficients for H. pylori in Models with Fasting Serum Concentrations of Risk Factors of the Insulin Resistance Syndrome

Variable

Beta

SE beta

P

Insulin

1.25

3.18

0.70

Glucose*

1.41

1.57

0.38

Triglyceride

-0.84

9.65

0.93

Insulin Resistance Syndrome

Regression coefficients were computed for H. pylori infection status with dependent variables associated with the insulin resistance syndrome adjusting for age and ethnicity. In men with no history of diabetes, H. pylori infection was not significantly associated with HDL cholesterol, systolic blood pressure, waist-to-hip ratio, or body mass index, risk variables associated with the insulin resistance syndrome. canadian pharmacy cialis

In the subset of 764 fasting men aged 40-74 with no history of diabetes, weighted regression coefficients adjusted for age, ethnicity, and body mass index were computed for H. pylori infection status with fasting serum insulin and plasma glucose, blood measurements of insulin resistance, and glucose tolerance (Table 2). Infection status was not associated with fasting serum insulin (p=0.70), the best measure in this survey of insulin resistance, plasma glucose (p=0.38), nor with fasting serum triglycerides (p=0.93).