幽门螺杆菌感染与糖化血红蛋白水平的关系探讨

Association between Helicobacter pylori infection and glycosylated hemoglobin levels

分析2011年于本院体检中心进行健康体检者中体检数据完整、进行了^13C-尿素呼气试验检测幽门螺杆菌（Hp）及糖化血红蛋白检测的11514名受试者的体检数据。结果显示，女性Hp阳性检出率（31．77％）高于男性（29．36％），X^2=7，355，P〈0．05。35～60岁受试者Hp阳性检出率最高，为31．17％。体重指数≥28kg／m^2者及有中心型肥胖者Hp阳性检出率相对较高，分别为31．55％及30．44％，但与正常体重及无中心型肥胖者比较，差异无统计学意义。总人群中，Hp阳性患者糖化血红蛋白水平高于Hp阴性者（t=-2．276，P=0．01）。亚组分析显示，体重指数≥24kg／m。及有中心型肥胖的受试者中，Hp阳性患者的糖化血红蛋白水平高于Hp阴性者（P〈0．05）。Hp阳性与糖尿病患病率呈正相关（OR=1．282；95％CI：0．941～1．799），在肥胖患者中相关性更明显（OR=1．459；95％C1：1．070～2．071）。提示，Hp阳性患者糖化血红蛋白水平较高。Hp可能参与血糖调节受损的发生，且可能与高体重指数相关。

The health check-up results of 11 514 subjects in 2011 at Beijing Hospital were retrospectively analyzed, including the results of 13C urea breath test for detection of Helicobacter pylori （Hp） and HbAlc test. The results showed that the prevalence rate of Hp infection was significantly higher in females （31.77%） than that of males （29. 36% ） （X^2 = 7. 355, P 〈 0. 05） ; the highest prevalence was found in 35 -60 y age group （31.17%）. Hp positive rates in subjects with body mass index （BMI） ≥28 kg/m^2 and central obesity were 31.55% and 30. 44% , respectively; there were no significant differences from those with normal weight and non central obesity. Subjects with positive Hp infection had higher levels of HbAlc, compared to those with negative Hp infection （t = -2. 276, P = 0. 01 ）. In subjects with BMI~〉 24 kg/m2 and central obesity, HbAlc level was higher in Hp positive subjects than that in Hp negative ones （P 〈 0. 05）. Diabetes mellitus was positively associated with Hp infection （ OR 1. 282; 95% CI 0. 941 - 1. 799）, particularly in obese patients （ OR 1. 459 ; 95 % CI 1. 070 - 2.071 ）. The results indicate that Hp may be involved in the impairment of glucose regulation, particularly in those with higher body mass index.