Long-term Effects of the Eradication of Helicobacter pylori on Metabolic Parameters, Depending on Sex, in South Korea
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Background/Aims: Helicobacter pylori (HP) infection is positively associated with metabolic syndrome (MS). However, the long-term effects of eradication therapy on MS and sex differences have not been thoroughly studied. We aimed to investigate the long-term effects of HP eradication on MS and sex differences. Methods: This study included 2,267 subjects who visited a tertiary referral center between May 2003 and May 2019. HP was diagnosed by histology, a Campylobacter-like organism test, and culture, and the subjects were prospectively followed up. The participants were categorized into three groups: HP uninfected, HP infected but non-eradicated, and HP eradicated. The baseline characteristics and changes in metabolic parameters after HP eradication were compared over a 5-year follow-up period. Results: Among 1,521 subjects, there was no difference in baseline metabolic parameters between the HP-uninfected (n=509) and HP-infected (n=1,012) groups, regardless of sex. Analysis of the metabolic parameters during follow-up among HP-uninfected (n=509), HP-non-eradicated (n=346), and HP-eradicated (n=666) groups showed that high-density lipoprotein (HDL) and the body mass index (BMI) increased after eradication, with a significant difference at 1-year of follow-up. In females, HDL increased after eradication (p=0.023), and the BMI increased after eradication in male subjects (p=0.010). After propensity score matching, the HDL change in female remained significant, but the statistical significance of the change in BMI in the male group became marginally significant (p=0.089). Conclusions: HP eradication affected metabolic parameters differently depending on sex. HDL significantly increased only in females over time, especially at 1-year of follow-up. In contrast, BMI showed an increasing tendency over time in males, especially at the 1-year follow-up.
Abstract
Background/Aims: Helicobacter pylori (HP) infection is positively associated with metabolic syndrome (MS). However, the long-term effects of eradication therapy on MS and sex differences have not been thoroughly studied. We aimed to investigate the long-term effects of HP eradication on MS and sex differences. Methods: This study included 2,267 subjects who visited a tertiary referral center between May 2003 and May 2019. HP was diagnosed by histology, a Campylobacter-like organism test, and culture, and the subjects were prospectively followed up. The participants were categorized into three groups: HP uninfected, HP infected but non-eradicated, and HP eradicated. The baseline characteristics and changes in metabolic parameters after HP eradication were compared over a 5-year follow-up period. Results: Among 1,521 subjects, there was no difference in baseline metabolic parameters between the HP-uninfected (n=509) and HP-infected (n=1,012) groups, regardless of sex. Analysis of the metabolic parameters during follow-up among HP-uninfected (n=509), HP-non-eradicated (n=346), and HP-eradicated (n=666) groups showed that high-density lipoprotein (HDL) and the body mass index (BMI) increased after eradication, with a significant difference at 1-year of follow-up. In females, HDL increased after eradication (p=0.023), and the BMI increased after eradication in male subjects (p=0.010). After propensity score matching, the HDL change in female remained significant, but the statistical significance of the change in BMI in the male group became marginally significant (p=0.089). Conclusions: HP eradication affected metabolic parameters differently depending on sex. HDL significantly increased only in females over time, especially at 1-year of follow-up. In contrast, BMI showed an increasing tendency over time in males, especially at the 1-year follow-up.
참고문헌 (42)
- Suerbaum S, "Helicobacter pylori infection", N Engl J Med, 347, pp.1175~1186 (2002)
- Upala S, "Association between Helicobacter pylori infection and metabolic syndrome : a systematic review and meta-analysis", J Dig Dis, 17, pp.433~440 (2016)
- Hooi JKY, "Global prevalence of Helicobacter pylori infection : systematic review and metaanalysis", Gastroenterology, 153, pp.420~429 (2017)
- Papamichael KX, "Helicobacter pylori infection and endocrine disorders : is there a link?", World J Gastroenterol, 15, pp.2701~2707 (2009)
- Won Seok Kim, "Long-term effect of the eradication of Helicobacter pylori on the hemoglobin A1c in type 2 diabetes or prediabetes patients", The Korean Journal of Internal Medicine, 37(3), pp.579~590 (2022), 대한내과학회[DOI]
- Wang B, "A metaanalysis of the association between Helicobacter pylori infection and risk of atherosclerotic cardiovascular disease", Helicobacter, 25, pp.e12761~ (2020)
- Alvarez-Arellano L, "Helicobacter pylori and neurological diseases : married by the laws of inflammation", World J Gastrointest Pathophysiol, 5, pp.400~404 (2014)
- Leontiadis GI, "Non-gastrointestinal tract associations of Helicobacter pylori infection", Arch Intern Med, 159, pp.925~940 (1999)
- Franceschi F, "Extragastric diseases and Helicobacter pylori", Helicobacter, 20(Suppl 1), pp.40~46 (2015)
- Eckel RH, "The metabolic syndrome", Lancet, 365, pp.1415~1428 (2005)
- Aguilar M, "Prevalence of the metabolic syndrome in the United States, 2003-2012", JAMA, 313, pp.1973~1974 (2015)
- Ford ES, "Increasing prevalence of the metabolic syndrome among U. S. adults", Diabetes Care, 27, pp.2444~2449 (2004)
- Lee SE, "Trends in the prevalence of metabolic syndrome and its components in South Korea : findings from the Korean National Health Insurance Service Database(2009-2013)", PLoS One, 13, pp.e0194490~ (2018)
- Lim S, "Increasing prevalence of metabolic syndrome in Korea : the Korean National Health and Nutrition Examination Survey for 1998-2007", Diabetes Care, 34, pp.1323~1328 (2011)
- Lim SH, "Positive association between Helicobacter pylori infection and metabolic syndrome in a Korean population : a multicenter nationwide study", Dig Dis Sci, 64, pp.2219~2230 (2019)
- Chen TP, "Helicobacter pylori infection is positively associated with metabolic syndrome in Taiwanese adults : a cross-sectional study", Helicobacter, 20, pp.184~191 (2015)
- Gunji T, "Helicobacter pylori infection is significantly associated with metabolic syndrome in the Japanese population", Am J Gastroenterol, 103, pp.3005~3010 (2008)
- Chen YY, "Helicobacter pylori infection increases risk of incident metabolic syndrome and diabetes : a cohort study", PLoS One, 14, pp.e0208913~ (2019)
- Park Y, "Eradication of Helicobacter pylori infection decreases risk for dyslipidemia : a cohort study", Helicobacter, 26, pp.e12783~ (2021)
- Iwai N, "Helicobacter pylori eradication increases the serum high density lipoprotein cholesterol level in the infected patients with chronic gastritis : a singlecenter observational study", PLoS One, 14, pp.e0221349~ (2019)
- Watanabe J, "The effect of Helicobacter pylori eradication on lipid levels : a meta-analysis", J Clin Med, 10, pp.904~ (2021)
- Adachi K, "Effects of Helicobacter pylori eradication on serum lipid levels", J Clin Biochem Nutr, 62, pp.264~269 (2018)
- Liou JM, "Long-term changes of gut microbiota, antibiotic resistance, and metabolic parameters after Helicobacter pylori eradication : a multicentre, open-label, randomised trial", Lancet Infect Dis, 19, pp.1109~1120 (2019)
- Pellicano R, "Clinical and biochemical parameters related to cardiovascular disease after Helicobacter pylori eradication", Int Angiol, 28, pp.469~473 (2009)
- Mokhtare M, "The effects of Helicobacter pylori eradication on modification of metabolic syndrome parameters in patients with functional dyspepsia", Diabetes Metab Syndr, 11(Suppl 2), pp.S1031~S1035 (2017)
- Upala S, "Effects of Helicobacter pylori eradication on insulin resistance and metabolic parameters : a systematic review and metaanalysis", Eur J Gastroenterol Hepatol, 29, pp.153~159 (2017)
- Azuma T, "Eradication of Helicobacter pylori infection induces an increase in body mass index", Aliment Pharmacol Ther, 16(Suppl 2), pp.240~244 (2002)
- Lane JA, "Randomised clinical trial : Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo-controlled study", Aliment Pharmacol Ther, 33, pp.922~929 (2011)
- Nayoung Kim, "Effect of Helicobacter pylori Eradication on the Development of Refl ux Esophagitis and Gastroesophageal Refl ux Symptoms: A Nationwide Multi-Center Prospective Study", Gut and Liver, 5(4), pp.437~446 (2011), 거트앤리버 소화기연관학회협의회
- Azuma T, "Gastric leptin and Helicobacter pylori infection", Gut, 49, pp.324~329 (2001)
- Nwokolo CU, "Plasma ghrelin following cure of Helicobacter pylori", Gut, 52, pp.637~640 (2003)
- Gokcel A, "Helicobacter pylori has no effect on plasma ghrelin levels", Eur J Endocrinol, 148, pp.423~426 (2003)
- Osawa H, "Changes in plasma ghrelin levels, gastric ghrelin production, and body weight after Helicobacter pylori cure", J Gastroenterol, 41, pp.954~961 (2006)
- Link JC, "Genetic basis for sex differences in obesity and lipid metabolism", Annu Rev Nutr, 37, pp.225~245 (2017)
- Godsland IF, "Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein(a)concentrations : analysis of studies published from 1974-2000", Fertil Steril, 75, pp.898~915 (2001)
- Ambikairajah A, "Lipid profile differences during menopause : a review with meta-analysis", Menopause, 26, pp.1327~1333 (2019)
- 김경배, "Males with Obesity and Overweight", Journal of Obesity & Metabolic Syndrome, 29(1), pp.18~25 (2020), 대한비만학회[DOI]
- 강영호, "Trends in General and Abdominal Obesity among Korean Adults: Findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys", Journal of Korean Medical Science, 25(11), pp.1582~1588 (2010), 대한의학회
- Ando T, "Differential normalization of mucosal interleukin-8 and interleukin-6activity after Helicobacter pylori eradication", Infect Immun, 66, pp.4742~4747 (1998)
- Choi Y, "Effect of Helicobacter pylori eradication after subtotal gastrectomy on the survival rate of patients with gastric cancer : follow-up for up to 15 years", Gastric Cancer, 23, pp.1051~1063 (2020)
- Benedetto U, "Statistical primer : propensity score matching and its alternatives", Eur J Cardiothorac Surg, 53, pp.1112~1117 (2018)
- 백승희, "Propensity Score Matching: A Conceptual Review for Radiology Researchers", Korean Journal of Radiology, 16(2), pp.286~296 (2015), 대한영상의학회[DOI]