Helicobacter pylori Infection Significantly Increases InsulinResistance in the Asymptomatic Japanese Population

摘要

Background: Helicobacter pylori infection has been shown to contribute toatherosclerosis and cardiovascular diseases. Insulin resistance is the patho-physiologic background of the clinical features of atherosclerosis and cardio-vascular diseases. We examined the association between H. pylon infectionand insulin resistance in a large Japanese population. Materials and Methods: Fifteen hundred ninety-eight consecutive asymp-tomatic subjects that underwent a complete medical survey in our institutebetween May 2007 and July 2008 were recruited. Cases under medicationfor hypertension, hyperlipidemia, diabetes mellitus, hyperuricemia, or car-diovascular diseases were excluded from the study. Cases suffering fromchronic renal or liver failure were also excluded. The homeostasis modelassessment of insulin resistance (HOMA-IR) score was used to quantitativelyestimate insulin resistance. Visceral and subcutaneous adipose tissues (SAT)were measured by computed tomography. The association between H. pylonserostatus and HOMA-IR score was investigated by multivariate regressionanalysis. Results: A total of 988 men and 119 women were eventually eligible forthis cross-sectional survey. Helicobacter pylon seropositivity was significantlyhigher in 99 cases with insulin resistance (HOMA-IR 2.5) compared with1008 cases without insulin resistance (HOMA-IR <2.5) (39.4 vs 28.7%,p = .027). There was a significant association between H. pylon serostatusand HOMA-IR score by multiple linear regression analysis (coeffi-cients = 0.152, 95% CI = 0.058-0.246, p = .001), after adjusting for sex, age,body mass index, waist girth, visceral and subcutaneous adipose tissues,smoking status, alcohol consumption, dietary habits, and physical activity. Conclusions: Helicobacter pylori infection significantly and independentlycontributed to promoting insulin resistance in a large asymptomaticpopulation.