Long-term Effects of the Eradication of Helicobacter pylori on Metabolic Parameters, Depending on Sex, in South Korea

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.

Interactions between Helicobacter pylori infection and host metabolic homeostasis: A comprehensive review

“…64 However, another prospective observational study with up to 5 years of follow-up suggested that H. pylori-eradicated (n = 666) patients, particularly females, exhibited higher HDL-C levels compared to those with H. pylori-uninfected (n = 509) and H. pylori-non-eradicated (n = 346) individuals at the first-year follow-up (−0.87 ± 10.52 vs. −2.38 ± 10.47 vs. 3.05 ± 9.61 mg/dL, p = 0.023). 65 The choice of any of the three eradication algorithms did not diminish the variability in lipid profiles associated with eradication therapy. 66 In addition to metabolic syndromes, H. pylori-related lipid alterations also depend on the interaction between gut microbiota.…”

“…In a more recent cohort study conducted in Korea with 131 H. pylori eradication patients and a matched control group using propensity score matching, after a median follow‐up of 610 (range: 154–1250) days and 606 (range: 154–1648) days, increased serum TG levels were observed in the H. pylori eradication group (135 ± 78 to 153 ± 100 mg/dL vs. 128.92 ± 65.62 to 130.13 ± 64.25 mg/dL, difference: 20.56 vs. 5.74 mg/dL), while differences in BMI changes between the two groups were not significant 64 . However, another prospective observational study with up to 5 years of follow‐up suggested that H. pylori ‐eradicated ( n = 666) patients, particularly females, exhibited higher HDL‐C levels compared to those with H. pylori ‐uninfected ( n = 509) and H. pylori ‐non‐eradicated ( n = 346) individuals at the first‐year follow‐up (−0.87 ± 10.52 vs. −2.38 ± 10.47 vs. 3.05 ± 9.61 mg/dL, p = 0.023) 65 . The choice of any of the three eradication algorithms did not diminish the variability in lipid profiles associated with eradication therapy 66 …”

Preventive effect of Helicobacter pylori eradication on the coronary heart diseases depending on age and sex with a median follow‐up of 51 months

“…Recently, H. pylori eradication has been associated with a decrease in hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) or prediabetes (preDM) over a long‐term follow‐up period, especially in males aged <65 years 4 . In addition, high‐density lipoprotein (HDL) level significantly increase over time only in females after H. pylori eradication, especially at 1 year follow‐up 25 . Thus, we hypothesized that age and sex could interfere the effect of H. pylori eradication on the CHD prevention.…”

“…4 In addition, high-density lipoprotein (HDL) level significantly increase over time only in females after H. pylori eradication, especially at 1 year follow-up. 25 Thus, we hypothesized that age and sex could interfere the effect of H. pylori eradication on the CHD prevention. Thus, to this end, we aimed to investigate the effect of H. pylori eradication on CHD development according to age and sex.…”

Changes in Metabolic Parameters by Helicobacter pylori Eradication According to Sex Differences

“…5 Investigating changes in metabolic parameters after H. pylori eradication can also determine the effect of H. pylori infection on MS and dyslipidemia. In that regard, Park et al 6 reported in an issue of Gut and Liver that H. pylori eradication-related alteration in metabolic parameters varied by sex. This prospective observational study divided the participants into three groups based on their H. pylori status: H. pylori-uninfected (n=509), H. pylorinon-eradicated (n=346), and H. pylori-eradicated (n=666).…”