Hindawi Publishing Corporation International Journal of Chronic Diseases Volume 2015, Article ID 290128, 6 pages http://dx.doi.org/10.1155/2015/290128
Research Article Relationship between Helicobacter pylori Infections in Diabetic Patients and Inflammations, Metabolic Syndrome, and Complications Yusuf Kayar,1 Özgül Pamukçu,2 Hatice EroLlu,2 Kübra Kalkan Erol,2 Aysegul Ilhan,3 and Orhan Kocaman1 1
Division of Gastroenterology, Internal Medicine Department, Bezmialem Vakif University, Turkey Internal Medicine Department, S¸is¸li Etfal Training and Research Hospital, Turkey 3 Sisli Etfal Hamidiye Education and Research Hospital, Clinics of Internal Medicine, Turkey 2
¨ ul Pamukc¸u; [email protected] Correspondence should be addressed to Ozg¨ Received 18 August 2014; Revised 10 December 2014; Accepted 21 December 2014 Academic Editor: Kathleen Gillespie Copyright © 2015 Yusuf Kayar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Helicobacter pylori infection and diabetes mellitus are two independent common diseases. It is showed that the worsening glycemic and metabolic control increases the rates of Helicobacter pylori infections and Helicobacter pylori is shown as one of the common problems in diabetic patients with complaints of gastrointestinal diseases. In this study, we aimed to investigate the prevalence and eradication rates of Helicobacter pylori in diabetic patients and the relationship of Helicobacter pylori with the risk factors and diabetic complications. In our study, in which we have included 133 patients, we have shown a significant relationship between Helicobacter pylori infections and metabolic syndrome, insulin resistance, inflammations, and diabetic complications.
1. Introduction Helicobacter pylori (HP) infections are very common worldwide, affecting approximately 50% of the world’s population, and are more common especially in developing countries [1]. Although the findings of various studies are inconsistent, the presence of H. pylori is found to be higher in diabetic patients compared to nondiabetic patients [2–4]. H. pylori colonizes in the gastric antrum in all patients, particularly in diabetic patients with impaired metabolic control [2–5]. Beside the well-defined gastric effects of H. pylori infection, some studies are also published pointing the extragastric effects of H. pylori infection which plays an additional role for the vascular damage in course of atherosclerosis [5, 6]. The presence of H. pylori and diabetes mellitus (DM) is one of the main causes of gastrointestinal diseases [2, 7]. Additionally, the presence of H. pylori in DM cases plays an important role in the development of gastrointestinal diseases [7]. In particular, the worsening of glycemic and metabolic control increases the incidence of H. pylori infections and
complaints of dyspepsia [2, 7]. A significant relationship between dyslipidemia and H. pylori has been reported. In prospective studies, it has been shown that H. pylori eradication improves dyslipidemia and insulin resistance and decreases inflammation [6]. Although the relationship between H. pylori infection and DM and the complications secondary to diabetes is not clear, it is known that neuropathy and hyperglycemia play an important role in H. pylori colonization in the gastric epithelium [8]. Although the findings of various studies are inconsistent, it has been shown that there is a significant relationship between microvascular complications (nephropathy, neuropathy, and retinopathy) and H. pylori [6, 9, 10]. Although there is no clear-cut consensus in the literature, it has been reported that HPeradication is noticeably lower in diabetic patients. There are a limited number of studies on the factors that play a role in HPeradication. We investigated the HP prevalence, HP eradication rates, and confounding factors affecting HP eradication in diabetic patients.
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International Journal of Chronic Diseases Table 1: The relationship between H. pylori positivity and inflammatory parameters.
Variables CRP∗ Leukocytes Thrombocytes Sedimentation∗ Ferritin∗ Fibrinogen∗ ∗
Total 4.8 ± 3.4 7.0 ± 1.8 250 ± 65 9.4 ± 8.2 86.5 ± 91.7 321 ± 77
H. pylori (+) subjects 5.5 ± 3.9 7.1 ± 1.6 252 ± 69 11.3 ± 8.9 122 ± 105 336 ± 82
H. pylori (−) subjects 3.9 ± 2.3 6.9 ± .9 248 ± 61 7.3 ± 6.8 45.6 ± 47 303 ± 67
𝑃 value 7 were found to be H. pylori positive (Table 3). The rate of H. pylori eradication in diabetic and control groups was 62.5% and 93.5%, respectively. The factors affecting the rate of H. pylori eradication were shown in Table 4. When the relationship between the complications in diabetic patients and H. pylori eradication was evaluated, a significant relationship between nephropathy and neuropathy with successful eradication of H. pylori was detected. Although retinopathy is more common in patients without H. pylori eradication, no statistical significance was detected.
International Journal of Chronic Diseases
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Table 2: The relationship between H. pylori positivity and demographic, clinical, and anthropometric parameters. Variables Gender Female Male Age Body mass index Normal Overweight Obese Waistline∗ Hypertension Yes∗ No Cholesterol ≥200
Research Article Relationship between Helicobacter pylori Infections in Diabetic Patients and Inflammations, Metabolic Syndrome, and Complications Yusuf Kayar,1 Özgül Pamukçu,2 Hatice EroLlu,2 Kübra Kalkan Erol,2 Aysegul Ilhan,3 and Orhan Kocaman1 1
Division of Gastroenterology, Internal Medicine Department, Bezmialem Vakif University, Turkey Internal Medicine Department, S¸is¸li Etfal Training and Research Hospital, Turkey 3 Sisli Etfal Hamidiye Education and Research Hospital, Clinics of Internal Medicine, Turkey 2
¨ ul Pamukc¸u; [email protected] Correspondence should be addressed to Ozg¨ Received 18 August 2014; Revised 10 December 2014; Accepted 21 December 2014 Academic Editor: Kathleen Gillespie Copyright © 2015 Yusuf Kayar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Helicobacter pylori infection and diabetes mellitus are two independent common diseases. It is showed that the worsening glycemic and metabolic control increases the rates of Helicobacter pylori infections and Helicobacter pylori is shown as one of the common problems in diabetic patients with complaints of gastrointestinal diseases. In this study, we aimed to investigate the prevalence and eradication rates of Helicobacter pylori in diabetic patients and the relationship of Helicobacter pylori with the risk factors and diabetic complications. In our study, in which we have included 133 patients, we have shown a significant relationship between Helicobacter pylori infections and metabolic syndrome, insulin resistance, inflammations, and diabetic complications.
1. Introduction Helicobacter pylori (HP) infections are very common worldwide, affecting approximately 50% of the world’s population, and are more common especially in developing countries [1]. Although the findings of various studies are inconsistent, the presence of H. pylori is found to be higher in diabetic patients compared to nondiabetic patients [2–4]. H. pylori colonizes in the gastric antrum in all patients, particularly in diabetic patients with impaired metabolic control [2–5]. Beside the well-defined gastric effects of H. pylori infection, some studies are also published pointing the extragastric effects of H. pylori infection which plays an additional role for the vascular damage in course of atherosclerosis [5, 6]. The presence of H. pylori and diabetes mellitus (DM) is one of the main causes of gastrointestinal diseases [2, 7]. Additionally, the presence of H. pylori in DM cases plays an important role in the development of gastrointestinal diseases [7]. In particular, the worsening of glycemic and metabolic control increases the incidence of H. pylori infections and
complaints of dyspepsia [2, 7]. A significant relationship between dyslipidemia and H. pylori has been reported. In prospective studies, it has been shown that H. pylori eradication improves dyslipidemia and insulin resistance and decreases inflammation [6]. Although the relationship between H. pylori infection and DM and the complications secondary to diabetes is not clear, it is known that neuropathy and hyperglycemia play an important role in H. pylori colonization in the gastric epithelium [8]. Although the findings of various studies are inconsistent, it has been shown that there is a significant relationship between microvascular complications (nephropathy, neuropathy, and retinopathy) and H. pylori [6, 9, 10]. Although there is no clear-cut consensus in the literature, it has been reported that HPeradication is noticeably lower in diabetic patients. There are a limited number of studies on the factors that play a role in HPeradication. We investigated the HP prevalence, HP eradication rates, and confounding factors affecting HP eradication in diabetic patients.
2
International Journal of Chronic Diseases Table 1: The relationship between H. pylori positivity and inflammatory parameters.
Variables CRP∗ Leukocytes Thrombocytes Sedimentation∗ Ferritin∗ Fibrinogen∗ ∗
Total 4.8 ± 3.4 7.0 ± 1.8 250 ± 65 9.4 ± 8.2 86.5 ± 91.7 321 ± 77
H. pylori (+) subjects 5.5 ± 3.9 7.1 ± 1.6 252 ± 69 11.3 ± 8.9 122 ± 105 336 ± 82
H. pylori (−) subjects 3.9 ± 2.3 6.9 ± .9 248 ± 61 7.3 ± 6.8 45.6 ± 47 303 ± 67
𝑃 value 7 were found to be H. pylori positive (Table 3). The rate of H. pylori eradication in diabetic and control groups was 62.5% and 93.5%, respectively. The factors affecting the rate of H. pylori eradication were shown in Table 4. When the relationship between the complications in diabetic patients and H. pylori eradication was evaluated, a significant relationship between nephropathy and neuropathy with successful eradication of H. pylori was detected. Although retinopathy is more common in patients without H. pylori eradication, no statistical significance was detected.
International Journal of Chronic Diseases
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Table 2: The relationship between H. pylori positivity and demographic, clinical, and anthropometric parameters. Variables Gender Female Male Age Body mass index Normal Overweight Obese Waistline∗ Hypertension Yes∗ No Cholesterol ≥200
