Helicobacter pylori Seropositivity in Nigerians with Type 2 Diabetes Mellitus

摘要

Background: Data on the relationship between H. pylori infection and diabetes mellitus are scarce and discordant. Objective: A case-control study has been conducted to investigate the relationship between infection with Helicobacter pylori and type 2 diabetes mellitus in Abakaliki, south eastern Nigeria; a region with high H. pylori endemicity. Materials & Methods: The study population comprised 60 type 2 diabetics (32 males and 28 females) and 60 non-diabetics (27 males and 33 females) aged 29 to 72 years. Hematological and biochemical parameters were determined using standard techniques while Helicobacter pylori detection in serum was done by an enzyme-linked immunosorbent assay for the identification of immunoglobulin G. Results: There was no statistically significant difference (p > 0.05) in the prevalence of H. pylori infection and dyspeptic symptoms between diabetics and non-diabetics. Although H. pylori-infected diabetics were significantly older (63.71 vs. 51.95 years; p = 0.00) and had significantly lower fasting plasma glucose (7.96 vs. 11.58 mmol/l; p = 0.01) than the non-infected diabetics, the two groups had comparable hematological and biochemical parameters. Conclusion: H. pylori seropositivity and dyspeptic symptoms were similar in type 2 diabetics and non-diabetics, although H. pylori infection when present in diabetics appears to influence glycaemic status, the mechanism of which remains largely unknown. Introduction Infection with Helicobacter pylori has been recognized as a public health problem worldwide [1] affecting approximately 50% of the world population and more prevalent in developing than the developed countries [2]. Helicobacter pylori infection has been associated with both gastrointestinal and non-gastroenterological conditions such as peptic ulcer (gastric and duodenal), gastric cancer and cardiovascular disease [3,4,5]. As one of the most common chronic bacteria infections in the world [6], coupled with the susceptibility of diabetic patients to a wide range of infections as a result of chronic elevation of blood glucose level and impairment of immune functions [7,8], researchers have hypothesized an association between infection with Helicobacter pylori and diabetes mellitus [1,9]. However, studies to date have failed to confirm this hypothesis as results have been discordant [10,11,12]. In Nigeria, there is paucity of information on the association between H. pylori infection and diabetes mellitus. The aim of this study is to investigate the relationship between infection with Helicobacter pylori and type 2 diabetes mellitus in Abakaliki, South Eastern Nigeria; a region with high H. pylori endemicity [13]. Materials And Methods This study was conducted in Abakaliki at the Ebonyi State University Teaching Hospital (EBSUTH) from May to November 2007. The study area has been previously defined [13]. The Research and Ethics Committee of Ebonyi State University Teaching Hospital, Abakaliki approved the proposal for this study. Participants were known type 2 diabetes mellitus patients on regular management at the Medical Out-patient Clinic of the Department of Internal Medicine, Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. Before enrolment, patients were adequately educated on the need for this study after which willing participant signed written informed consents. At entry into the study each participant was administered with a structured questionnaire to obtain sociodemographic data such as age, sex, level of education, occupation, smoking habits, alcohol intake, duration of diabetes, drug treatment, and symptoms of dyspepsia. Dyspeptic symptoms were regarded as present if the patient complained of any of the following: epigastric pain, bloating, nausea, and vomiting, early satiety, weight loss, GI bleeding or combinations of these symptoms and absent if none was present. Height and weight were measured with the subject in light clothes without shoes, and BMI (Kg/m2) was calcul