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14-03-2012 | Gastroenterology | Article

H. pylori infection could increase diabetes risk

Abstract

Free abstract

MedWire News: Study results suggest that Helicobacter pylori infection is associated with higher levels of glycated hemoglobin (HbA1c), which could lead to an increased risk for Type 2 diabetes in infected individuals.

The researchers found that the association was stronger than expected in people with higher body mass index (BMI) and H. pylori infection, suggesting a "synergistic interaction" between the two factors.

As reported in the Journal of Infectious Diseases, Yu Chen and Martin Blaser of the New York University School of Medicine, USA, carried out a cross-sectional study of 7417 National Health and Nutrition Examination Survey (NHANES) III and 6072 NHANES 1999-2000 participants who were aged 18 years, or 3 years and above, respectively, to assess links between H. pylori infection and Type 2 diabetes risk.

The team found no significant link between a self-reported history of diabetes and H. pylori infection.

However, after controlling for various confounders and exclusion of people with previously reported diabetes, a significant positive association between H. pylori infection and HbA1c level was observed (0.07-0.70 % greater HbA1c in infected vs noninfected individuals).

Of note, H. pylori infection combined with higher BMI (25 kg/m2 or above) appeared to result in significantly greater HbA1c levels than might be expected by the addition of the two factors alone. The association was also more evident in those aged 18 years or above than in younger individuals.

Chen and Blaser hypothesize that H. pylori may adversely influence levels of leptin and ghrelin in the gut leading to increased HbA1c levels, particularly in overweight or obese individuals.

"Given that the prevalence of H. pylori is decreasing, the proportion of diabetes that could be attributable to H. pylori is likely to also decrease," write the authors.

"However, among older individuals and especially those with a higher BMI, glucose intolerance associated with H. pylori could remain significant," they say, adding that these patients could benefit from eradication of H. pylori using antibiotics.

Writing in an accompanying editorial, Dani Cohen and Khitam Muhsen (Tel Aviv University, Israel) comment: "If confirmed, the findings reported by Chen and Blaser on the link between H. pylori infection and HbA1c could have important clinical and public health implications.

"H. pylori-infected adults with higher BMI, even if asymptomatic, may need anti-H. pylori therapy to control or prevent diabetes mellitus."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Helen Albert

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