幽门螺杆菌感染对代谢综合征患者血糖血脂代谢的影响

Effect of Helicobacter pylori infection on blood glucose and lipid metabolism in patients with metabolic syndrome

目的分析幽门螺杆菌(Hp)感染对代谢综合征患者血糖血脂代谢的影响。方法对2017年11月-2020年11月于济宁医学院附属医院就诊的1196例代谢综合征患者进行研究。依据^(14)C-尿素呼气试验结果将1196例代谢综合征患者分为Hp阳性组(n=498)和Hp阴性组(n=698)。对两组的血脂、血糖相关指标水平进行比较,对两组各项血脂、血糖异常率和其余临床资料进行比较,并归纳Hp阳性的影响因素。结果Hp阳性组的体质量指数(BMI)、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)高于Hp阴性组(P<0.05);Hp阳性组的血清葡萄糖(GLU)、空腹血糖(FBG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA1c)和空腹胰岛素(FINS)高于Hp阴性组(P<0.05);Hp阳性组的BMI、甘油三酯、总胆固醇、LDL-C、GLU、FBG、2h PG、HbA1c和FINS异常率高于Hp阴性组(P<0.05);Hp阳性组的体质量、腰围、臀围、腰臀比(WHR)高于Hp阴性组(P<0.05);回归过程采用逐步后退法,以进行自变量的选择和剔除,设定α剔除=0.10,α入选=0.05。回归结果提示:体质量指数(BMI)、甘油三酯、GLU、FBG是Hp阳性的影响因素(P<0.05)。结论Hp感染会加重代谢综合征患者的血糖和血脂代谢紊乱,增大各项血脂、血糖异常发生率,且糖脂代谢紊乱也为Hp感染的影响因素。

OBJECTIVE To analyze the effect of H.pylori(HP)infection on blood glucose and lipid metabolism in patients with metabolic syndrome.METHODS Using prospective analysis research methods,1196 patients with metabolic syndrome who were treated in the Affiliated Hospital of Jining Medical College from Nov.2017 to Nov.2020 were studied.According to the results of^(14)C urea breath test,1196 patients with metabolic syndrome were divided into Hp positive group(n=498)and Hp negative group(n=698).The levels of blood lipid and blood glucose-related indicators of the two groups were compared,the abnormal rates of blood lipid and blood glucose and other clinical data of the two groups were compared,and the influencing factors of Hp positive were analyzed by multivariate analysis.RESULTS The body mass index(BMI),triglyceride,total cholesterol and low-density lipoprotein cholesterol(LDL-C)of the Hp positive group were signigifcantly higher than those of the Hp negative group(P<0.05).Serum glucose(GLU),fasting blood glucose(FBG),2 h postprandial blood glucose(2 H PG),HbA1 c and fasting insulin(FINS)levels in the Hp positive group were signigifcantly higher than those of the Hp-negative group(P<0.05).The abnormal rate of BMI,triglyceride,total cholesterol,LDL-C,GLU,FBG,2 H PG,HbA1 c and FINS in the Hp positive group were signigifcantly higher than those of the Hp-negative group(P<0.05).The body mass,waist circumference,hip circumference and WHR of the Hp positive group were signigifcantly higher than those of the Hp-negative group(P<0.05).In the regression process,the stepbackward method was adopted to select and eliminate the independent variables,with elimination=0.10 and inclusion=0.05.The regression results suggested that BMI,triacylglycerol,GLU,and FBG were the influencing factors of Hp positive(P<0.05).CONCLUSION Hp infection could aggravate the disorder of blood glucose and blood lipid metabolism in patients with metabolic syndrome,increase the incidence of abnormalities of blood lipid and blood glucose,and the disorder of blood glucose and lipid metabolism was also influencing factors for Hp infection.