The Relationship betweenH. pyloriInfection and Osteoporosis in Japan

Abstract

Background and Objective. H. pylori infection causes a chronic inflammation in the gastric mucosa. However, this local inflammation may result in extra-digestive conditions. Our aim is to investigate the relationship between H. pylori infection and osteoporosis in Japan. Methods. This cross-sectional study was conducted among outpatients at the Juntendo University Hospital between 2008 and 2014. Participants for patient profile, H. pylori infection status, comorbidity, internal medical therapies, lumbar dual-energy X-ray absorptiometry (DXA), and bone turnover marker were collected and upper gastrointestinal endoscopy for reflux esophagitis, hiatal hernia, peptic ulcer disease (PUD), and endoscopic gastric mucosal atrophy (EGA) was performed. The diagnosis of osteoporosis was performed in accordance with the Japanese criteria. We investigated risk factors of osteoporosis. Results. Of the eligible 200 study subjects, 41 cases were of osteoporosis. Bivariate analysis showed that age, being female, BMI, alcohol, smoking, H. pylori, bone-specific ALP, PUD, and EGA were related to osteoporosis. Multivariate analysis showed that age (OR 1.13; 95%CI 1.07–1.20), being female (OR 4.77; 95%CI 1.78–12.77), BMI (OR 0.79; 95%CI 0.68–0.92), H. pylori (OR 5.33; 95%CI 1.73–16.42), and PUD (OR 4.98; 95%CI 1.51–16.45) were related to osteoporosis. Conclusions. H. pylori infection may be a risk factor of osteoporosis in Japan.

Analysis of the associations among Helicobacter pylori infection, adiponectin, leptin, and 10-year fracture risk using the fracture risk assessment tool: A cross-sectional community-based study

“…Four studies reported a positive association between H . pylori infection and osteoporosis [22,27–29]. Figura et al [22] reported that male patients infected by CagA protein–producing H .…”

“…pylori strains had higher values of a urinary bone fracture biomarker. Two hospital-based studies from Japan by Asaoka et al [27,29] and 1 from Taiwan by Lin et al [28] reported an association between H . pylori infection and osteoporosis.…”

Decrease of Estradiol and Several Lifestyle Factors, but Not <b><i>Helicobacter pylori</i></b> Infection, Are Significant Risks for Osteopenia in Japanese Females

“…This study similarly divided subjects into 2 groups at age 50, and a significant relationship was noted between age (50 years or older) and osteopenia [19]. Causes may include reduced osteoblast function and calcium absorption due to aging [34,35].…”

“…Recently, a meta-analysis using 5 studies [15,18,20,21,44] from Asian countries demonstrated that H. pylori infection does not seem to be an important factor related to osteopenia [45]. However, some previous studies showed a relationship between H. pylori infection and osteoporosis [16,17,18,19,20,21]. In most of these studies, H. pylori infection was diagnosed by serum anti- H. pylori IgG antibody titers or histology.…”

“…Previous studies from Western countries have reported a null relationship between H. pylori infection and osteoporosis [14,15]. On the other hand, since Figura et al [16] reported the relationship between osteoporosis and men infected with CagA-positive H. pylori , several studies from East Asia and Japan have demonstrated a relationship between H. pylori infection and osteoporosis [17,18,19,20,21]. Thus, the relationship between H. pylori infection and osteoporosis are still controversial.…”