Gastric Helicobacter pylori infection is associated with adverse metabolic traits in severely obese subjects

Abstract

Objective: Asian studies have reported on an association of Helicobacter pylori (Hp) infection with insulin resistance (IR) in normal-weight subjects. Whether such an association likewise exists in European subjects with severe obesity was questioned. Design and Methods: To address this question, 370 severely obese patients from our database were identified, who had undergone a gastroscopy with a histological examination of gastric mucosal biopsies and a concurrent assessment metabolic blood parameters as a standard examination before bariatric surgery. Results: Seventy-five (20.3%) of the subjects displayed a histologically proven Hp infection (Hpþ). Sex distribution, age, and body mass index of Hpþ subjects did not differ from that of the subjects with no Hp infection (Hp-; all P > 0.293), but Hpþ subjects were significantly smaller (P ¼ 0.006). Fasting glucose, insulin, high-sensitive C reactive protein, and alanine aminotransferase levels as well as calculated indices of IR (i.e., HOMA-IR, QUICKI) did not differ between Hpþ and Hp-subjects (all P > 0.42). However, Hpþ subjects showed significantly higher triglyceride levels and a higher total chloesterol-to-HDL ratio but lower sex-hormone binding globulin (SHGB) levels than Hp-subjects (all P 0.05). Conclusion: While our results obtained in European severely obese patients do not provide evidence for an enhanced IR state associated with gastric Hp infection, they suggest that the presence of the bacterium in gastric biopsies is associated with an adverse lipid profile and reduced SHGB levels.

Central obesity is associated with helicobacter pylori infection: a large-scale cross-sectional retrospective study in West China

“…A study [24] including 370 severely obese patients showed that the BMI of H. pylori-positive subjects did not differ from that of H. pylori-negative subjects. Ioannou et al [25] noted that the status of H. pylori/CagA antibody was not related with obesity.…”

Association between Helicobacter pylori infection and metabolic syndrome: a systematic review and meta‐analysis

“…Another 34 articles were excluded (12 were not observational studies, one did not include control group, one duplicate, and the other 20 did not report an outcome of interest). Subsequently, 18 studies including 15 cross‐sectional studies and three cohort studies involving 27 544 participants met our inclusion criteria and were included in the meta‐analysis. The search methodology is outlined in Fig.…”

Interaction of obesity and infections

“…Weight gain was observed across BMI ranges and was higher than control populations where H. pylori was not eradicated. Nineteen studies evaluated cross-sectional association of H. pylori and obesity (18)(19)(20)(21)(22)(23). Eleven studies found evidence of higher prevalence of H. pylori infection in obese individuals or metabolic impairment in the presence of the infection (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

“…While the numbers of studies in these additional categories are small, some results are trending in specific directions. For example, the prevalence of periodontal disease, respiratory Helicobacter pylori (6)(7)(8)(9)(10)(11)(12)(13)(18)(19)(20)(21)(22)(23) Eradication is associated with weight gain Ad36 (37,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)195) Associated with obesity and fat mass gain Post-surgical infections Higher incidence of surgical site infections, post-operative infections, deep sternal wound infections and blood stream infections in obese patients. Longer hospital stays and more readmissions in obesity Class 2 and 3 obesity (BMI > 35 and 40) is associated with more severe post-surgical infection.…”