Abstracts
Association between Helicobacter pylori infection and risk of new-onset diabetes: a community-based, prospective cohort study Mengge Zhou, Jing Liu, Yue Qi, Ying Wang, Miao Wang, Fan Zhao, Zhizhong Gong, Shen Gao, Dong Zhao
Abstract Published Online November 17, 2016 Beijing An Zhen Hospital, Capital Medical University, Beijing, China (M Zhou MD, Prof J Liu PhD, Y Qi PhD, Y Wang PhD, M Wang MPH, F Zhao PhD, Z Gong MD, S Gao MD, Prof D Zhao PhD); The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China (M Zhou, Prof J Liu, Y Qi, Y Wang; M Wang, F Zhao, Z Gong, S Gao, Prof D Zhao); and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China (M Zhou, Prof J Liu, Y Qi, Y Wang; M Wang, F Zhao, Z Gong, S Gao, Prof D Zhao) Correspondence to: Prof Dong Zhao, Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China
[email protected]
Background Helicobacter pylori infection affects about 50% of the population worldwide. Results from previous studies, most of which were cross-sectional, on the association between H pylori infection and diabetes were inconsistent. We aimed to examine the association between H pylori infection and the risk of new-onset diabetes. Methods In this prospective cohort study, we recruited participants aged 45–74 years without diabetes from the Chinese Multi-provincial Cohort Study—Beijing Project, a community-based cohort study. H pylori serostatus (with seropositivity defined as anti-H pylori antibodies ≥10 U/mL, measured by latex-enhanced turbidimetric immunoassay), and diabetes status (with diabetes identified by self-report, fasting blood glucose concentration ≥7 mmol/L, or selfreported use of glucose-lowering drugs) were recorded at baseline, in 2007, and in 2012. We used multivariable logistic regression models to estimate the independent association between H pylori infection and diabetes risk. Ethics approval was granted by the ethics committee of Beijing An Zhen Hospital, Capital Medical University, and all participants provided written informed consent. Findings Of 1671 participants (686 [41%] men; mean age 56·6 years [SD 7·8]), 966 (58%) were positive for H pylori infection at baseline. Between 2002 and 2012, 206 (12%) incident diabetes cases were recorded. After adjustment for other well known or potential risk factors of diabetes (including age, BMI, HDL, triglyceride, lipid-lowering therapy, smoking, hypertension, C-reactive protein, baseline fasting blood glucose level, and education level), H pylori infection was associated with a reduced risk of new-onset diabetes at 10 years (odds ratio 0·70, 95% CI 0·50–0·99) and at 5 years (0·82, 0·53–1·26 in 2002–07; 0·51, 0·30–0·87 in 2007–12). When participants with high fasting blood glucose (≥6·1 mmol/L) at baseline were excluded, H pylori infection was still associated with a reduced risk of new-onset diabetes (0·73, 0·51–1·03 in 2002–12; 0·83, 0·52–1·31 in 2002–07, 0·45, 0·22–0·93 in 2007–12). Of 1408 participants with anti-H pylori antibody measurements in both 2002 and 2007, 746 (53%) were persistently seropositive. Compared with participants who were persistently seronegative, those who were persistently seropositive had lower risk of newonset diabetes at 5 years (0·50, 0·29–0·86). Of 725 participants who had anti-H pylori antibody measurements at all three timepoints (2002, 2007, and 2012), those who were persistently seropositive had a reduced risk of diabetes (0·70, 0·41–1·21). Interpretation H pylori infection is associated with a lower risk of new-onset diabetes in Chinese adults aged 45–74 years. The extrapolation of these results and the underlying mechanism for observed association need further investigation. Funding Participants recruitment and data collection were supported by Beijing Municipal Science & Technology Commission (953850700), the National Science & Technology Pillar Program during the Eleventh Five-Year Plan Period (2006BAI01A01 and 2006BAI01A02), and the National Science & Technology Pillar Program during the Twelfth Five-Year Plan Period (2011BAI09B01). Study design, data analysis and interpretation, and other pertinent aspects of the study were funded by the National Natural Science Foundation of China (81170266, 81070226, and 81570409). Contributors DZ and JL conceived and designed the study. DZ and MZ drafted the Abstract. MZ, YQ, and SG did the literature search. MW, YW, FZ, and ZG collected data. MZ, SG, and YQ did the statistical analysis. MZ, JL, YQ, YW, and DZ revised the Abstract for intellectual contents. All authors interpreted the results and approved the final submitted version of the Abstract. Declaration of interests All authors received all relevant reagents for anti-H pylori antibodies measurements from Denka Seiken.
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