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헬리코박터 파이로리 감염과 대사성질환

Helicobacter pylori Infection and Metabolic Disease

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초록

헬리코박터 파이로리가 발견된 이래로 “이 특이한 세균이 위장관계 질환 외에 다른 여러 질환을 일으키지 않을까?” 하는 질문을 수많은 연구자들이 던졌었고 역학연구 및 병리학적 근거를 찾기 위한 연구를 지속하여 왔다. 이러한 질문 중 대부분은 아직 명확한 답을 얻지 못하고 있는 실정이다. 과연 헬리코박터 파이로리 감염이 비만을 일으키는지 혹은 제균치료 후 체중이 늘어나는 현상이 헬리코박터 파이로리가 제거된 뒤 그렐린의 증가에 따른 현상인지 아직은 모호한 실정이다. 또한 헬리코박터 파이로리 감염 시 인슐린 저항성은 증가하는 것으로 보이나 당뇨병의 발병에까지 기여한다는 증거는 없다. 다만 비록 뇌혈관 질환과의 관련성은 불명확하나 헬리코박터 파이로리 감염이 만성화 되면 지질조성의 변화를 가져와 동맥경화를 심화시키는 위험인자로서 작용하며 심혈관 질환의 이환율을 높이는 것은 어느 정도 정설로 받아들여지는 것으로 보인다. 병태생리와는 별도로, 몇몇 연구에서 밝혀진 바와 같이 헬리코박터 파이로리 제균은 당뇨병의 혈당조절, 지질대사 이상의 교정, 심혈관 질환의 재발률 저하에 효과를 보인다고 여겨지고 있으므로 이러한 환자에서는 헬리코박터 파이로리 제균을 적극적으로 고려하는 것이 바람직하다고 생각한다. 더욱이 이런 환자에서 재감염의 위험 등을 고려하여 볼 때 헬리코박터 파이로리 백신이 개발된다면 큰 도움이 될 수 있을 것이다.

Abstract

The topic of the extragastric manifestations of Helicobacter pylori infection continues to capture the attention of many researchers all over the world. There are, in fact, several studies concerning obesity, diabetes mellitus, cardiovascular diseases, lung diseases, hematologic diseases, eye and skin diseases, hepatobiliary diseases, and neurological disorders. Among them, obesity and related disorders are hot spots in modern society. Here, we review the results of the studies about the relationship between Helicobacter pylori infection and obesity related diseases.

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