Prevalence and association of Helicobacter pylori infection in patients with metabolic syndrome: A case-control study

Isam  Yousif Mansoor; Sameer Merkhan Ahmed

doi:10.15218/zjms.2025.016

Authors

Isam Yousif Mansoor Department of Medical Microbiology, College of Health Science, Hawler Medical University, Erbil, Iraq.
Sameer Merkhan Ahmed Ble General Hospital-Erbil Diroctrate of Health

DOI:

https://doi.org/10.15218/zjms.2025.016

Keywords:

Helicobacter pylori, Metabolic syndrome

Abstract

Background and objective: Helicobacter pylori infection and metabolic syndrome are two progressive factors noticed in developing countries, but their association is still controversial. This study aimed to determine the prevalence and association of Helicobacter pylori infection in both subjects with and without metabolic syndrome.

Methods: A case-control study was conducted at the Ble General Hospital, 658 subjects taken and divided into two groups first those who were diagnosed as metabolic syndrome (328 subjects) and second control group (330 subjects). Helicobacter pylori-specific IgG antibody and some biochemical tests were performed for both groups besides other parameters like blood pressure and BMI.

Results: Having metabolic syndrome is associated with a higher probability of having Helicobacter pylori Abs (OR = 1.6; 95% CI = 1.096-2.341). Age group 40-49 years had more probability to have Helicobacter pylori Abs (OR = 2.054; 95% CI = 1.086-3.883). The prevalence of metabolic syndrome reported higher in females (77.4 %). No significant differences were detected between the rapid method and the ELIZA method for the detection of stool Ag (P = 0.921) but differences were significant in the detection of Helicobacter pylori Abs (P <0.001).

Conclusion: The study demonstrates that having metabolic syndrome is associated with a higher probability of having Helicobacter pylori Abs compared with the controls. This study also showed immunochromatography is reliable for the detection of Helicobacter pylori stool Ag but not Ab.

Metrics

Metrics Loading ...

References

Tsay F-W, Hsu P-I. Helicobacter pylori infection and extra-gastroduodenal diseases. J Biomed Sci. 2018; 25(1):65. doi: 10.1186/s12929-018-0469-6.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112(17):2735-52. doi: 10.1161/circulationaha.105.169404.

de Brito BB, da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM, et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World J Gastroenterol. 2019; 25(37):5578-89. doi: 10.3748/wjg.v25.i37.5578.

Brito BBd, Lemos FFB, Carneiro CdM, Viana AS, Barreto NMPV, Assis GAdS, et al. Immune response to Helicobacter pylori infection and gastric cancer development. World Journal of Meta-Analysis. 2021. doi: 10.13105/wjma.v9.i3.257

Chen LW, Chien CY, Yang KJ, Kuo SF, Chen CH, Chien RN. Helicobacter pylori Infection Increases Insulin Resistance and Metabolic Syndrome in Residents Younger than 50 Years Old: A Community-Based Study. PLoS One. 2015; 10(5):e0128671 doi: 10.1371/journal.pone.0128671.

Jiang Y, Huang L, Zhou L. Association between obesity and Helicobacter pylori infection. Nutrition Clinique et Métabolisme. 2022; 36(3):210-6. doi: 10.1016/j.nupar.2022.07.003.

Hashim M, Mohammed O, T GE, Wolde M. The association of Helicobacter pylori infection with dyslipidaemia and other atherogenic factors in dyspeptic patients at St. Paul's Hospital Millennium Medical College. Heliyon. 2022; 8(5):e09430. doi: 10.1016/j.heliyon.2022.e09430.

Majeed PD, Khoshnaw KJS. Seroprevalence of Helicobacter pylori Infection among Patients with Gastroduodenal Disorders in Erbil City. Dwight's Journal of Music. 2020; 18:91-101. doi: 10.26505/djm.18014880818.

Hussein RA, Al-Ouqaili MTS, Majeed YH. Detection of Helicobacter pylori infection by invasive and non-invasive techniques in patients with gastrointestinal diseases from Iraq: A validation study. PLoS One. 2021; 16(8):e0256393. doi: 10.1371/journal.pone.0256393.

Ismael S, Ahmed H, Tahseen M. Prevalence of metabolic syndrome in a sample of population in Erbil city, Iraq. Zanco J Med Sci. 2016; 20:1280-7. doi: 10.15218/zjms.2016.0021.

Sayılar EI, Çelik B, Dumlu Ş. Relationship between Helicobacter pylori infection and metabolic syndrome. Turk J Gastroenterol. 2015; 26(6):468-73.

Takeoka A, Tayama J, Yamasaki H, Kobayashi M, Ogawa S, Saigo T, et al. Impact of Helicobacter pylori Immunoglobulin G Levels and Atrophic Gastritis Status on Risk of Metabolic Syndrome. PLOS ONE. 2016; 11(11):e0166588. doi: 10.1371/journal.pone.0166588.

Refaeli R, Chodick G, Haj S, Goren S, Shalev V, Muhsen K. Relationships of Helicobacter pylori infection and its related gastroduodenal morbidity with metabolic syndrome: a large cross-sectional study. Scientific Reports. 2018; 8(1):4088. doi: 10.1038/s41598-018-22198-9.

Chen TP, Hung HF, Chen MK, Lai HH, Hsu WF, Huang KC, et al. Helicobacter pylori Infection is Positively Associated with Metabolic Syndrome in Taiwanese Adults: a Cross-Sectional Study. Helicobacter. 2015; 20(3):184-91. doi: 10.1111/hel.12190.

Lim SH, Kim N, Kwon JW, Kim SE, Baik GH, Lee JY, et al. Positive Association Between Helicobacter pylori Infection and Metabolic Syndrome in a Korean Population: A Multicenter Nationwide Study. Digestive Diseases and Sciences. 2019; 64(8):2219-30. doi: 10.1007/s10620-019-05544-3.

White JR, Winter JA, Robinson K. Differential inflammatory response to Helicobacter pylori infection: etiology and clinical outcomes. J Inflamm Res. 2015; 8:137-47. doi: 10.2147/jir.s64888.

Beigh SH, Jain S. Prevalence of metabolic syndrome and gender differences. Bioinformation. 2012; 8(13):613-6. doi: 10.6026/97320630008613.

Yu Y, Cai J, Song Z, Wang J, Wu L. Association of Helicobacter pylori infection with metabolic syndrome in aged Chinese females. Experimental and Therapeutic Medicine. 2019; 17(6):4403-8. doi: 10.3892/etm.2019.7509.

Chen LW, Kuo SF, Chen CH, Chien CH, Lin CL, Chien RN. A community-based study on the association between Helicobacter pylori Infection and obesity. Sci Rep. 2018; 8(1):10746. doi: 10.1038/s41598-018-28792-1.

Arslan E, Atilgan H, Yavaşoğlu I. The prevalence of Helicobacter pylori in obese subjects. Eur J Intern Med. 2009; 20(7):695-7.

Baradaran A, Dehghanbanadaki H, Naderpour S, Pirkashani LM, Rajabi A, Rashti R, et al. The association between Helicobacter pylori and obesity: a systematic review and meta-analysis of case–control studies. Clinical Diabetes and Endocrinology. 2021; 7(1):15. doi: 10.1186/s40842-021-00131-w.

Misra A, Khurana L. Obesity and the Metabolic Syndrome in Developing Countries. The Journal of Clinical Endocrinology & Metabolism. 2008; 93(11_supplement_1):s9-s30. doi: 10.1210/jc.2008-1595.

Arslan E, Atılgan H, Yavaşoğlu İ. The prevalence of Helicobacter pylori in obese subjects. European Journal of Internal Medicine. 2009; 20(7):695-7 https://www.sciencedirect.com/science/article/pii/S0953620509001423.

Xu X, Li W, Qin L, Yang W, Yu G, Wei Q. Relationship between Helicobacter pylori infection and obesity in Chinese adults: A systematic review with meta-analysis. PLoS One. 2019; 14(9):e0221076. doi: 10.1371/journal.pone.0221076.

Lender N, Talley NJ, Enck P, Haag S, Zipfel S, Morrison M, et al. Review article: Associations between Helicobacter pylori and obesity--an ecological study. Aliment Pharmacol Ther. 2014; 40(1):24-31. doi: 10.1111/apt.12790.

Xu MY, Liu L, Yuan BS, Yin J, Lu QB. Association of obesity with Helicobacter pylori infection: A retrospective study. World J Gastroenterol. 2017; 23(15):2750-6. doi: 10.3748/wjg.v23.i15.2750.

Hegde V, Dhurandhar NV. Microbes and obesity--interrelationship between infection, adipose tissue and the immune system. Clin Microbiol Infect. 2013; 19(4):314-20. doi: 10.1111/1469-0691.12157.

Kim SW, Kim HJ, Min K, Lee H, Lee SH, Kim S, et al. The relationship between smoking cigarettes and metabolic syndrome: A cross-sectional study with non-single residents of Seoul under 40 years old. PLoS One. 2021; 16(8):e0256257. doi: 10.1371/journal.pone.0256257.

Wei L, Chen S, Qiang Y, Kuai L, Zhou M, Luo Y, et al. Tobacco smoking was positively associated with metabolic syndrome among patients with psoriasis in Shanghai: A cross-sectional study. Tob Induc Dis. 2022; 20(January):1-11. doi: 10.18332/tid/144228.

Wang J, Bai Y, Zeng Z, Wang J, Wang P, Zhao Y, et al. Association between life-course cigarette smoking and metabolic syndrome: a discovery-replication strategy. Diabetology & Metabolic Syndrome. 2022; 14(1):11. doi: 10.1186/s13098-022-00784-2.

Takeuchi T, Nakao M, Nomura K, Yano E. Association of metabolic syndrome with smoking and alcohol intake in Japanese men. Nicotine & Tobacco Research. 2009; 11(9):1093-8 https://www.jstor.org/stable/26762731.

Ignatius R, Berg C, Weiland C, Darmer A, Wenzel T, Lorenz M, et al. Accurate Detection of Helicobacter pylori Antigen in Human Stool Specimens by Two Novel Immunoassays. Eur J Microbiol Immunol (Bp). 2019; 9(2):29-31.

Korkmaz H, Findik D, Ugurluoglu C, Terzi Y. Reliability of stool antigen tests: investigation of the diagnostic value of a new immunochromatographic Helicobacter pylori approach in dyspeptic patients. Asian Pac J Cancer Prev. 2015; 16(2):657-60. doi: 10.7314/apjcp.2015.16.2.657.

Dalla Nora M, HÖRner R, De Carli DM, Rocha MPd, Araujo AFd, Fagundes RB. Is the immunocromatographic fecal antigen test effective for primary diagnosis of Helicobacter Pylori infection in dyspeptic patients? Arquivos de Gastroenterologia. 2016; 53. doi: 10.1590/s0004-28032016000400003.

Obaid J, Ayoon ANN, Almurisy ONM, Alshuaibi SMS, Alkhawlani NN. Evaluation of antibody immunochromatography testing for diagnosis of current Helicobacter pylori infection. Pract Lab Med. 2021; 26:e00245. doi: 10.1016/j.plabm.2021.e00245.

Shirin H, Bruck R, Kenet G, Krepel Z, Wardi Y, Reif S, et al. Evaluation of a new immunochromatographic test for Helicobacter pylori IgG antibodies in elderly symptomatic patients. Journal of Gastroenterology. 1999; 34(1):7-10. doi: 10.1007/s005350050209.