幽门螺杆菌感染对血脂、血糖、血尿酸及颈动脉粥样硬化的影响

Effects of Helicobacter Pylori infection on Human Metabolism and Carotid atherosclerosis

目的:调查本地区幽门螺杆菌(Hp)感染的流行情况,研究幽门螺杆菌感染对血脂、血糖、血尿酸及颈动脉粥样硬化的影响,分析Hp感染对颈动脉硬化影响的可能机制。方法:回顾性分析6043例体检人群的数据资料,根据Hp感染情况分为两组,阳性组1651例,阴性组4392例。在所有入选者中有2373人进行了颈动脉超声检查,根据颈动脉粥样硬化情况分为内中膜增厚、稳定斑块及不稳定斑块3组。所有数据采用SPSS 23.0软件进行统计分析,以P<0.05为差异有统计学意义。结果:(1)呼和浩特地区体检人群幽门螺杆菌感染阳性率为29.76%,Hp感染在性别、年龄及体质量质数(BMI)各组间比较差异均具有统计学意义(P<0.05),其中Hp感染率男性高于女性,且随年龄及BMI增大逐渐升高;(2)空腹血糖(FBG)与高密度脂蛋白胆固醇(HDL-C)水平在Hp阴性与阳性组之间均具有显著性差异(P<0.05),而总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及血尿酸(BUA)水平在两组间比较差异无统计学意义(P>0.05),Hp感染可以影响机体FBG和HDL-C的代谢水平;(3)Hp阳性者的FBG和HDL-C水平与性别、年龄、BMI均有显著相关性(P<0.05),男性Hp阳性者FBG水平显著高于女性,HDL-C水平显著低于女性,年龄增加可引起FBG与HDL-C水平增高,而BMI增加则可引起FBG水平增高、HDL-C水平下降。(4)Hp感染组颈动脉硬化发生率高于非Hp感染组患者(P=0.018),其中Hp感染组稳定及不稳定斑块检出率均高于非Hp感染组(P<0.05)。结论:本地区体检人群中大龄男性且超重人群更易感染幽门螺杆菌,而且Hp感染能引起机体血脂血糖水平代谢紊乱,导致FBG水平明显升高,HDL-C水平明显降低,进而促进了颈动脉硬化的发展,应对高风险人群开展相关健康教育和定期检查,及时正确地进行幽门螺杆菌筛查与干预,预防和减少动脉粥样硬化等相关疾病的发生发展。

Objective:To investigate the epidemic of helicobacter pylori infection in this region,to study the effect of helicobacter pylori infection on human metabolism and carotid atherosclerosis,and to analyze the possible mechanism of the influence of Hp infection on carotid atherosclerosis.Methods:Data of 6043 people undergoing 13C urea breath test in the health management center of our hospital from January 1,2017 to December 31,2018 were retrospectively analyzed,including 3198 males and 2845 females,aged 17-87 years,with an average age of(42.60±13.31)years.According to Hp infection,they were divided into two groups:1651 cases in the positive group and 4392 cases in the negative group.Carotid ultrasound examination was performed in 2373 of the selected subjects,who were divided into three groups based on carotid atherosclerosis:thickening of the medial membrane,stable plaque,and unstable plaque.All data were statistically analyzed by SPSS 23.0 software,and P<0.05 was considered as statistically significant.Results:(1)The positive rate of Helicobacter pylori in the physical examination population was 29.76%,and the difference in H.pylori infection between the groups of gender,age,and BMI was statistically significant(P<0.05).Among them,the Hp infection rate in men was higher than that in women(29.2%vs.25.2%),and the Hp infection rate gradually increased with age and BMI.The highest Hp infection rate was 33.0%in the 70-year-old group,and as high as 28.2%in the overweight group.(2)The levels of FBG and HDL-C were significantly different between the negative and positive groups of helicobacter pylorus infection(P<0.05),while the differences of TC,TG,LDL-C and BUA between the two groups were not statistically significant(P>0.05).Hp infection can affect the metabolic levels of FBG and hdl-c in the body.(3)The FBG and HDL-C levels of Hp-positive subjects were significantly correlated with gender,age and BMI(P<0.05).The FBG level of Hp-positive subjects was significantly higher than that of female subjects,while the HDL-C level was significantly lower than that of female subjects.Moreover,increasing age can lead to an increase in FBG and HDL-C levels,while increasing BMI can lead to an increase in FBG and a decrease in HDL-C levels.(4)The incidence of carotid atherosclerosis in the Hp infected group was higher than that in the non-HP infected group(P=0.018),and the detection rate of stable and unstable plaques in the Hp infected group was higher than that in the non-HP infected group(P<0.05).Conclusion:Older males and overweight people in the physical examination population in this region are more likely to be infected with Helicobacter pylori,and Hp infection can cause metabolic disorders of blood lipids and blood sugar levels in the body,leading to a significant increase in FBG levels and a significant decrease in HDL-C levels,which may affect the body’s inflammatory response and Lipid metabolism promotes the development of carotid atherosclerosis.Therefore,relevant health education and regular inspections should be carried out for high-risk groups,and Helicobacter pylori screening and intervention should be carried out in a timely and correct manner to prevent and reduce the occurrence and development of atherosclerosis and other related diseases.