Helicobacter pylori infection in physical examination population and its correlations with hypertension, glucose and lipid metabolism
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摘要:目的
探讨体检人群幽门螺杆菌(Hp)感染情况及其与高血压、糖脂代谢的关联性。
方法选取287例体检者作为研究对象。根据14C-尿素呼气试验筛查Hp感染结果, 将体检者分为Hp阳性组(n=125)和Hp阴性组(n=162)。比较2组基线资料和糖脂代谢水平。采用多因素Logistic回归分析法筛选体检人群Hp感染的影响因素。
结果287例体检者Hp感染率为43.55%。Hp阳性组的经常外出就餐率为34.40%, 高于Hp阴性组的13.58%, 差异有统计学意义(P < 0.05)。Hp阳性组的空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)高于Hp阴性组，高密度脂蛋白胆固醇(HDL-C)低于Hp阴性组，差异有统计学意义(P < 0.05)。多因素Logistic回归分析显示，外出就餐(OR=1.401, 95%CI: 1.142~1.717)、FBG(OR=3.865, 95%CI: 1.810~8.253)、TC(OR=4.141, 95%CI: 2.025~8.469)、TG(OR=4.259, 95%CI: 2.128~8.524)、HDL-C(OR=4.125, 95%CI: 1.989~8.552)是体检人群Hp感染的影响因素(P < 0.05), HOMA-IR与体检人群Hp感染无关(P>0.05)。
结论体检人群Hp感染率较高，且Hp感染与糖脂代谢异常存在显著相关性，但与高血压无相关性。
Abstract:ObjectiveTo investigate the infection of Helicobacter pylori (Hp) and its relationships with hypertension, glucose and lipid metabolism in the physical examination population.
MethodsA total of 287 individuals undergoing physical examinations were selected as study subjects. Based on the results of 14C-urea breath test screening for Hp infection, participants were divided into Hp-positive group (n=125) and Hp-negative group (n=162). Baseline characteristics and glycolipid metabolism levels were compared between the two groups. Multivariate Logistic regression analysis was used to identify factors influencing Hp infection in the study population.
ResultsThe Hp infection rate among the 287 individuals was 43.55%. The frequency of eating out in the Hp-positive group was 34.40%, which was significantly higher than 13.58% in the Hp-negative group (P < 0.05). Fasting blood glucose (FBG), insulin resistance index (HOMA-IR), total cholesterol (TC) and triacylglycerol (TG) in the HP-positive group were significantly higher, and high-density lipoprotein cholesterol (HDL-C) was significantly lower than that in the Hp-negative group (P < 0.05). Multivariate Logistic regression analysis revealed that eating out (OR=1.401, 95%CI, 1.142 to 1.717), FBG (OR=3.865, 95%CI, 1.810 to 8.253), TC (OR=4.141, 95%CI, 2.025 to 8.469), TG (OR= 4.259, 95%CI, 2.128 to 8.524) and HDL-C (OR=4.125, 95%CI, 1.989 to 8.552) were factors influencing Hp infection in the study population (P < 0.05). HOMA-IR was not associated with Hp infection in the study population (P>0.05).
ConclusionThe prevalence of Hp infection is high among individuals undergoing physical examinations, and Hp infection has significant association with abnormalities in glycolipid metabolism, but no association with hypertension.
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表 1 Hp阳性组和Hp阴性组的一般资料比较[n(%)]
项目 分类 Hp阳性组(n=125) Hp阴性组(n=162) χ2 P 年龄 18~44岁 26(20.80) 44(27.16) 1.779 0.411 45~59岁 53(42.40) 67(41.36) ≥60岁 46(36.80) 51(31.48) 性别 男 75(60.00) 78(48.15) 3.345 0.067 女 50(40.00) 84(51.85) 文化程度 初中及以下 62(49.60) 70(43.21) 1.600 0.450 高中及中专 41(32.80) 55(33.95) 大专及以上 22(17.60) 37(22.84) 职业 工人 35(28.00) 41(25.31) 6.042 0.196 务农 31(24.80) 38(23.46) 公务员 15(12.00) 13(8.02) 职员 30(24.00) 35(21.60) 其他 14(11.20) 35(21.60) 体质量指数 < 24 kg/m2 54(43.20) 87(53.70) 3.115 0.078 ≥24 kg/m2 71(56.80) 75(46.30) 饮酒 有 56(44.80) 58(35.80) 2.386 0.122 无 69(55.20) 104(64.20) 吸烟 有 50(40.00) 49(30.25) 2.970 0.085 无 75(60.00) 113(69.75) 饮食规律 是 48(38.40) 50(30.86) 1.782 0.182 否 77(61.60) 112(69.14) 外出就餐频率 经常(4~5次/月) 43(34.40) 22(13.58) 19.030 < 0.001 偶尔(2~3次/月) 46(36.80) 66(40.74) 极少(< 2次/月) 36(28.80) 74(45.68) 家族Hp感染病史 有 26(20.80) 28(17.28) 0.571 0.450 无 99(79.20) 134(82.72) 胃镜检查史 有 51(40.80) 57(35.19) 0.948 0.330 无 74(59.20) 105(64.81) 
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表 2 Hp阳性组和Hp阴性组血压及糖脂代谢指标比较($\overline x $ ±s)
指标 Hp阳性组(n=125) Hp阴性组(n=162) t P SBP/mmHg 131.89±7.69 130.28±6.57 1.910 0.057 DBP/mmHg 77.23±4.39 76.34±4.50 1.679 0.094 FBG/(mmol/L) 6.47±1.57 5.50±0.79 6.825 < 0.001 FINS/(mIU/L) 7.08±1.33 6.82±1.19 1.743 0.082 2 hPG/(mmol/L) 9.22±2.03 8.81±1.96 1.730 0.085 HbA1c/% 5.93±0.84 5.76±0.70 1.869 0.063 HOMA-IR 2.60±0.33 2.12±0.16 16.213 < 0.001 TC/(mmol/L) 5.64±0.51 4.52±0.25 24.415 < 0.001 TG/(mmol/L) 2.08±0.27 1.45±0.18 23.661 < 0.001 HDL-C/(mmol/L) 1.02±0.14 1.62±0.38 16.790 < 0.001 LDL-C/(mmol/L) 2.95±0.43 3.04±0.50 1.606 0.110 SBP: 收缩压; DBP: 舒张压; FBG: 空腹血糖; FINS: 空腹胰岛素; 2 hPG: 餐后2 h血糖; HbA1c: 糖化血红蛋白; HOMA-IR: 胰岛素抵抗指数; TC: 总胆固醇; TG: 甘油三酯; HDL-C: 高密度脂蛋白胆固醇; LDL-C: 低密度脂蛋白胆固醇。1 mmHg=0.133 kPa。
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表 3 Hp感染的多因素Logistic回归分析
变量 β SE Wald χ2 P OR 95%CI 外出就餐频率 0.337 0.104 10.500 0.001 1.401 1.142~1.717 FBG 1.352 0.387 12.205 0.001 3.865 1.810~8.253 HOMA-IR 0.207 0.113 3.356 0.068 1.230 0.986~1.535 TC 1.421 0.365 15.157 < 0.001 4.141 2.025~8.469 TG 1.449 0.354 16.754 < 0.001 4.259 2.128~8.524 HDL-C 1.417 0.372 14.510 < 0.001 4.125 1.989~8.552
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