title: Association of Helicobacter pylori infection with cardiovascular and cerebrovascular disease in diabetic patients.
abstract: OBJECTIVE
  Infection by Helicobacter pylori has been epidemiologically linked to some extradigestive conditions, including ischemic heart disease. Diabetic patients are an at-risk population for cardiovascular and thrombo-occlusive cerebral disease. The aim of the study was to examine a possible relationship between H. pylori infection and cardiovascular or cerebrovascular disease in diabetic patients.
  
  
  METHODS
  This was a cross-sectional case-control study with 127 diabetic patients (both IDDM and NIDDM). Special emphasis was placed on the detection of clinical macro- and microvascular complications, cardiovascular risk factors, acute phase reactants, and serological markers of increased cardiovascular disease risk. H. pylori infection was assessed through the determination of specific Ig-G titers, measured by a commercial enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Coronary heart disease was more prevalent in diabetic patients with than without H. pylori (odds ratio [OR] 4.07; 95% CI 1.21-13.6; P < 0.05). A history of thrombo-occlusive cerebral disease was also more frequent in H. pylori-positive diabetic patients (OR 4.8; 95% CI 1.24-18.51; P < 0.05). Other complications such as peripheral arteriopathy, advanced nephropathy, neuropathy, or retinopathy were no differently distributed according to serological status. Alterations in the levels of the following acute-phase reactants and blood chemistry determinations were significantly more profound in H. pylori-positive diabetic patients: high fibrinogen (P < 0.05), high erythrocyte sedimentation rate (P < 0.001), high triglycerides (P < 0.001), and low HDL cholesterol (P < 0.001). There values were also more deeply altered in H. pylori-positive diabetic patients with a history of coronary heart disease, thrombo-occlusive cerebral disease, or both, when compared with H. pylori-positive diabetic patients without those complications.
  
  
  CONCLUSIONS
  Our data indicate a possible association of H. pylori infection and the development of coronary heart disease, thrombo-occlusive cerebral disease, or both, in diabetic patients. The importance of this link is highlighted by the possibility of an effective intervention against H. pylori infection.
authors.affiliation: Department of Endocrinology, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain. daniel.deluis@hrc.es
authors.forename: D A
authors.initials: DA
authors.lastname: de Luis
authors.forename: M
authors.initials: M
authors.lastname: Lahera
authors.forename: R
authors.initials: R
authors.lastname: Cantón
authors.forename: D
authors.initials: D
authors.lastname: Boixeda
authors.forename: A L
authors.initials: AL
authors.lastname: San Román
authors.forename: R
authors.initials: R
authors.lastname: Aller
authors.forename: H
authors.initials: H
authors.lastname: de La Calle
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000382:microbiology*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000097:blood / Q000150:complications / Q000382:microbiology*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000382:microbiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000382:microbiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000382:microbiology; D003925:Diabetic Angiopathies / Q000150:complications / Q000382:microbiology*; D003928:Diabetic Nephropathies / Q000150:complications / Q000382:microbiology; D003929:Diabetic Neuropathies / Q000150:complications / Q000382:microbiology; D003930:Diabetic Retinopathy / Q000150:complications / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000382:microbiology*; D012307:Risk Factors
chemical_list: D015415:Biomarkers