Helicobacter pylori

INTRODUCTION

Few studies have examined the relationship of infection with Helicobacter pylori and prevalence of diabetes, increased serum insulin concentration, or insulin resistance, despite the relationship postulated for all these variables with coronary heart disease (CHD), and atherosclerosis. Some studies report higher prevalence of infection with H. pylori in persons with type-2 or type-1 than in nondiabetics, while others do not. No study was found of the association of infection with H. pylori and glucose utilization measured using a hyperinsulinemic euglycemic clamp, the best indicator of insulin resistance. The existence of an independent association of H. pylori infection status with future risk of myocardial infarction (MI) has been reported in a few studies but not in others, an association in unadjusted analysis often being greatly or completely diminished after adjusting for confounders. One study found a strong association of H. pylori status with prevalence of coronary disease, stroke, and HDL and triglyceride concentration in a series of diabetics. Studies of infection with H. pylori and obesity or other risk factors failed to find a consistent association. Well-established are associations of metabolic risk factor clustering with insulin sensitivity and hyperinsulinemia, the metabolic syndrome.

In order to test the null hypothesis that prevalences of MI, type-2 diabetes, and some of the variables comprising the metabolic syndrome are not significantly associated with exposure to H. pylori infection independent of gender, age, or ethnicity, data from the Third National Health and Nutrition Examination Survey (NHANES III) were examined.