Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study

Shih, Hong-Mo; Hsu, Tai-Yi; Chen, Chih-Yu; Lin, Cheng‐Li; Kao, Chia‐Hung; Chen, Chao-Hsien; Yang, Tse-Yen; Chen, Wei-Kung

doi:10.1371/journal.pone.0162645

Cited by 24 publications

(28 citation statements)

References 38 publications

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“…H. pylori infection causes chronic gastritis and induces a permanent inflammatory response that may increase both the gastric and the systemic indexes of inflammation, such as TNF- α , IL-1, and IL-6 [ 35 ]. Shih et al demonstrated that H. pylori infection may be associated with an increased risk of developing osteoporosis in elderly female patients with upper gastrointestinal diseases [ 36 ]. Meantime, Figura et al found that H. pylori infection by strains expressing CagA may be considered a risk factor for osteoporosis in men [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Helicobacter pylori Infection and Metabolic Abnormality in General Population: A Cross-Sectional Study

Hao

Liu

et al. 2018

Gastroenterology Research and Practice

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Background Previous studies have suggested a link between Helicobacter pylori (H. pylori) and metabolic abnormality. This study aimed at investigating the correlation between H. pylori infection and metabolic abnormality in a general population. Methods All enrolled participants underwent a carbon-13 urea breath test (13C-UBT). For each individual, the following data were collected: age, gender, alanine transaminase (ALT), total protein, albumin, cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), urea nitrogen, creatinine, uric acid, fasting plasma glucose, postprandial blood sugar, nonalcoholic fatty liver disease (NAFLD), and bone mineral density (BMD). Results The study included 1867 (393 females and 1474 males, aged 54.0 ± 9.6 years) people that took a physical examination. There was no significant difference in gender and age between the study participants with and without H. pylori infection. The statistical data are as follows: albumin: P = 0.045, uric acid: P = 0.025, fasting glucose: P = 0.043, and postprandial blood glucose: P = 0.035. In terms of the patients with NAFLD, there were significant differences in ALT and HDL-C between the study participants with and without H. pylori infection. TG (P = 0.048), HDL-C (P = 0.011), and fasting blood glucose (P = 0.018) were significantly different in both groups among individuals who got osteopenia. Conclusion H. pylori infection may be an important factor affecting metabolic abnormality and osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Correlation between Helicobacter pylori Infection and Metabolic Abnormality in General Population: A Cross-Sectional Study

Hao

Liu

et al. 2018

Gastroenterology Research and Practice

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“…11 A very interesting safety study looked at any association between H. pylori eradication therapy and the development of osteoporosis, a highly relevant topic in the context of recent data linking PPI use to osteoporosis. 12 An increase in the risk of developing osteoporosis was found to be higher in the early H. pylori treatment (within 1 year of diagnosis) cohort and also in the late H. pylori treatment cohort, compared with controls; however, when the follow-up period was over 5 years, only the late eradication group exhibited a higher incidence of osteoporosis. This may imply that early eradication could reduce any potential influence of H. pylori infection on osteoporosis either directly or by reducing PPI use.…”

Section: Triple Therapymentioning

confidence: 83%

“…In terms of safety, a Japanese study of 322 patient showed a 15% incidence of diarrhea and 2% risk of skin rash . A very interesting safety study looked at any association between H. pylori eradication therapy and the development of osteoporosis, a highly relevant topic in the context of recent data linking PPI use to osteoporosis . An increase in the risk of developing osteoporosis was found to be higher in the early H. pylori treatment (within 1 year of diagnosis) cohort and also in the late H .…”

Section: Triple Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2017

et al. 2017

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Over the last decade, it has been widely reported that the success of Helicobacter pylori eradication treatment is falling. A steady decline was observed in the number of patients achieving eradication with standard first-line triple therapy of two antibiotics and a proton pump inhibitor [1][2][3]. It now appears that the first-line eradication therapies most commonly used in everyday clinical practice fall considerably short of the 80% intention-to-treat (ITT) eradication rates that are considered the minimal acceptable levels as recommended in the Maastricht guidelines [4]. Interestingly, two studies emerged from Asian centers in the last 12 months, which show that, in this part of the world at least, eradication levels using standard therapies remain close to 80%. A Malaysian study showed a standard 1-week pantoprazole, amoxycillin, and clarithromycin regimen to be well tolerated and highly efficacious with a per-protocol eradication rate of 84% [5]. A Japanese study showed remarkably consistent per-protocol eradication rates from 2001 to 2009 fluctuating between 75 and 78% for standard 7-day triple-therapy regimens [6]. A limit of many studies especially those including clarithromycin or levofloxacin is that H. pylori susceptibility to the drugs, which is the main prediction of failure, was not tested. LevofloxacinThe use of levofloxacin as a first-line therapy has been examined in great depth in the last year. Levofloxacin may be used as a substitute for clarithromycin in either a standard triple or sequential regimen. A large study comparing the antibiotics in either regimen shows a clear advantage to levofloxacin in both combinations. Per-protocol cure rates for triple therapy were 66% for omeprazole-clarithromycin-amoxycillin compared with 83% for omeprazole-levofloxacin-amoxycillin and 81% for omeprazole-amoxycillin-clarithromycin-metronidazole vs 85% for omeprazole-amoxycillin-levofloxacinmetronidazole, with no difference in compliance rates or adverse events [7]. It has been proposed that sequential levofloxacin-based regimens are of most benefit in areas where clarithromycin resistance is in excess of 15%, and another study in such an area showed eradication rates of 81% with clarithromycin sequential therapy compared with 96% with levofloxacin sequential therapy. A third arm in this study looked at the dose of levofloxacin required and illustrated no benefit in increasing the dose from 250 to 500 mg [8]. Indeed, another study went so far as to suggest that once-daily dosing of a levofloxacin-based triple regimen may be as efficacious as twice daily [9]. The literature from Asia also seems to support levofloxacin as a good alternative first-line therapy. A study on a triple regimen showed per-protocol eradication rates of 78% for standard clarithromycin-containing therapies compared with 83% for a levofloxacin-based regimen [10]. Another study from the Middle East looked at whether combining clarithromycin and levofloxacin in the same regimen could be Keywords Peptic ulcer disease, resistance, compli...

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“…Although H. pylori infection causing a decrease in bone density is supported by most researchers, the effect of early eradication therapy is still insu cient. Replogle ML holds the view that early eradication therapy may eliminate chronic in ammation from H. pylori 37 . Some articles have also reported an improvement in B12 levels after complete eradication 13,38 , which requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

H. pylori is related to osteoporosis but only in premenopausal female: a cross-sectional study

Wang

Dong

et al. 2020

Preprint

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BackgroundRecently, an increasing number of studies have focused on the extra-gastrointestinal effects of Helicobacter pylori (H. pylori) , including metabolic syndrome, fatty liver, and rheumatic and skin diseases. Osteoporosis is an asymptomatic disease that can eventually lead to fractures and has a significant impact on the quality of life of elderly individuals. Sex is an influential factor that plays a crucial role in the development of osteoporosis. The aim of this study was to investigate the relationship between H. pylori infection and osteoporosis and to identify potential influencing factors.MethodsWe conducted a cross-sectional study of individuals older than 50 years old, who had undergone regular physical examinations at the Beijing Shijitan Hospital Health Examination Center from July to October 2018 . We evaluated the associations of osteopenia and osteoporosis with H. pylori infection and related serum markers by using multiple linear regression and logistic regression. Then, we analysed the correlation between sex and potential serum biomarkers.ResultsThere were significant relationships between H. pylori infection status and bone density in premenopausal females but not in males ( P =0.381) according to Fisher's exact test. In females , H. pylori positivity (OR=0.132, P =0.023), Body Mass Index( BMI ) (OR=28.163, P =0.021), and homocysteine (HCY) (OR=17.218, P =0.045) were associated with osteoporosis. Calcium had a trend but no statistically significant (OR=0.060, P=0.076) relationship with osteoporosis. Furthermore, the waist -to- hip ratio (OR=5.783, P =0.029), BMI (OR=0.152, P =0.014) and triglyceride levels (OR=0.201, P =0.036) were significantly different by sex, after adjusting for age as a confounder.ConclusionH. pylori positivity , BMI and HCY are associated with osteoporosis in premenopausal females . Chronic inflammation may be involved in the relationship between H. pylori and osteoporosis.

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Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study

Cited by 24 publications

References 38 publications

Correlation between Helicobacter pylori Infection and Metabolic Abnormality in General Population: A Cross-Sectional Study

Correlation between Helicobacter pylori Infection and Metabolic Abnormality in General Population: A Cross-Sectional Study

Treatment of Helicobacter pylori infection 2017

H. pylori is related to osteoporosis but only in premenopausal female: a cross-sectional study

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