Helicobacter pyloriInfection and Insulin Resistance in Diabetic and Nondiabetic Population

Abstract

Helicobacter pylori (HP) is a common worldwide infection with known gastrointestinal and nongastrointestinal complications. One of the gastrointestinal side effects posed for this organism is its role in diabetes and increased insulin resistance. The aim of this study was to evaluate the association between HP and insulin resistance in type 2 diabetic patients and nondiabetics. This cross-sectional study was carried out from May to December 2013 on 211 diabetic patients referred to diabetes clinic of Shahid Beheshti Hospital of Qom and 218 patients without diabetes. HP was evaluated using serology method and insulin resistance was calculated using HOMA-IR. The prevalence of H. pylori infection was 55.8% and 44.2% in diabetics and nondiabetics (P = 0.001). The study population was divided into two HP positive and negative groups. Among nondiabetics, insulin resistance degree was 3.01 ± 2.12 and 2.74 ± 2.18 in HP+ and HP− patients, respectively (P = 0.704). Oppositely, insulin resistance was significantly higher in diabetic HP+ patients rather than seronegative ones (4.484 ± 2.781 versus 3.160 ± 2.327, P = 0.013). In diabetic patients, in addition to higher prevalence of HP, it causes a higher degree of insulin resistance.

Randomized, double-blind, placebo-controlled trial to evaluate the effect of Helicobacter pylori eradication on glucose homeostasis in type 2 diabetic patients

“…These findings are in agreement with previous studies, which hypothesized that HP infection significantly and independently contributed to promoting insulin resistance in diabetic subjects [18,19,37]. This trend toward a possible association between HP infection and insulin sensitivity has been highlighted by a recent systematic review of literature on the topic [14].…”

“…Conflicting in vivo results have been published on this possible relationship between HP and type 2 diabetes [13,14]. Some publications have shown no correlation between HP infection and glucose homeostasis [15][16][17], whereas others have reported that HP infection significantly contributes to promoting insulin resistance [18][19]. Furthermore, the seroprevalence risk of HP infection among patients with diabetes is still controversial.…”

Extragastric Diseases and Helicobacter pylori

“…Moreover, other authors investigated a possible role of H. pylori in insulin resistance; on this subject, Vafaeimanesh et al. reported not only a higher prevalence of H. pylori in patients with diabetes, but also a positive association with insulin resistance. While these data perfectly match the results obtained in previous studies , more recently Zhou et al.…”

“…Similarly, Horikawa et al [9] showed how H. pylori infection significantly worsens glycemic control in patients with diabetes. Moreover, other authors investigated a possible role of H. pylori in insulin resistance; on this subject, Vafaeimanesh et al [10] reported not only a higher prevalence of H. pylori in patients with diabetes, but also a positive association with insulin resistance. While these data perfectly match the results obtained in previous studies [11], more recently Zhou et al [12] clearly demonstrated that H. pylori infection can induce hepatic insulin resistance by interfering with the c-Jun/miR-203/suppressor of cytokine signaling 3 (SOCS3) pathway both in humans and in an animal model, and another study showed a positive effect of H. pylori eradication on microalbuminuria in patients with DM [13].…”

Relationship Between Metabolic Parameters and Helicobacter Pylori Infections With Upper Gastrointestinal System Endoscopy and Gastric Histopathology Results in Patients With Dyspeptic Type 2 Diabetes Mellitus

“…Bazı yayınlarda HP infeksiyonu ile glukoz dengesi arasında korelasyon gösterilememiştir (4,5,6). Ancak HP infekksiyonunu anlamlı bir şekilde insulin direnci oluşturduğu bildirilmiştir (3,7,8).…”