Effect of Helicobacter pylori Eradication on Insulin Resistance, Serum Lipids and Low-grade Inflammation

Ramazan Gen, MD; Mehmet Demir, MD; Hilmi Ataseven, MD

Disclosures

South Med J. 2010;103(3):190-196. 

In This Article

Abstract and Introduction

Abstract

Background/aim: Many studies have revealed a close relationship between Helicobacter pylori (HP) infection and insulin resistance. The aim of this study was to investigate the effects of HP eradication on insulin resistance, serum lipids and low-grade inflammation.
Materials and methods: This was a prospective, open-label, single-center study which consisted of 159 patients. The patients with HP infection received a 14-day sequential regimen. A HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insulin resistance.
Results: Eighty-eight patients with HP infection and seventy-one patients without HP infection were studied. HOMA-IR, total cholesterol (TC), triglyceride (TG), LDL cholesterol (LDL-C) and C reactive protein (CRP) levels were significantly higher and HDL-cholesterol (HDL-C) levels were significantly lower in patients with HP infection compared to the patients without HP infection (P < 0.05). The HP eradication rates with a sequential regimen in dyspeptic patients were 53.4%. Six weeks after the end of eradication therapy, the mean fasting insulin, HOMA-IR, TC, TG, LDL-C, and CRP levels in patients with successful eradication were significantly decreased from the pretreatment levels (P < 0.05) and HDL-C level was significantly increased from the pretreatment levels (P < 0.05). The mean fasting insulin, HOMA-IR, TC, TG, LDL-C, CRP levels and HDL-C levels in patients with unsuccessful eradication were not significantly changed from pretreatment levels (P < 0.05).
Conclusion: This study showed beneficial effects of HP eradication on insulin resistance, atherogenic lipid abnormalities and low-grade inflammation. The results suggest that HP eradication may prevent coronary artery disease and metabolic syndrome.

Introduction

Helicobacter pylori (HP), a microaerophilic Gram-negative bacterium, infects the stomach of more than 50% of the human population worldwide and is a major cause of chronic gastritis, peptic ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer.[1] HP is also associated with coronary artery disease and its risk factors such as diabetes mellitus, atherogenic lipids and low-grade inflammation.[2–7] Studies have reported that impaired insulin action, which can be assessed by fasting serum insulin levels or homeostasis model assessment of insulin resistance (HOMA-IR) is associated with the development of atherosclerosis and an increased risk of myocardial infarction.[8] Insulin resistance may play a role in mediating the effects of HP infection on cardiovascular risk factors. Several studies have shown that HP is associated with insulin resistance[9,10] and metabolic syndrome.[11,12] To date, there is one retrospective study on the effect of HP eradication on insulin resistance,[13] but to our knowledge there are no prospective studies evaluating the effect of HP eradication on insulin resistance. In this prospective study, we aimed to investigate the effects of HP eradication on insulin resistance, serum lipids and low-grade inflammation.

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