Helicobacter pylori, gastrointestinal symptoms, and metabolic control in young type 1 diabetes mellitus patients.
OBJECTIVE
The role of Helicobacter pylori infection in metabolic control and gastrointestinal symptoms in type 1 diabetes mellitus (DM1) patients has been debated. The aim of this study was to investigate the prevalence of H pylori, of the more cytotoxic Cag-A-positive strains, and the effects of infection on gastrointestinal symptoms and metabolic control in young DM1 patients. Research Design and Methods. H pylori infection was investigated by using the 13C-urea breath test in 121 DM1 patients (65 males, 56 females; mean age: 15 +/- 6 years) and 147 matched controls. In positive patients, an assay for specific immunoglobulin G against Cag-A was performed. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were established; a questionnaire concerning the presence of dyspeptic symptoms was administered.


RESULTS
No difference in H pylori infection rate between patients and controls was observed. Thirty-four (28.1%) of 121 patients and 43 (29.25%) of 147 controls were infected. Twenty-one patients and 24 controls were positive for Cag-A. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were not affected by infection nor by Cag-A status. Among gastrointestinal symptoms, only halitosis was related to H pylori infection, but this association disappeared after correction for age. Positive patients with halitosis showed a worse glycemic control than uninfected patients with halitosis.


CONCLUSIONS
H pylori infection and Cag-A-positive strains do not affect metabolic control in DM1 patients. With regard to gastrointestinal symptoms studied, H pylori infection, when present in participants with halitosis, seems to predict a worse metabolic control than in H pylori-negative patients with halitosis.
Candelli
Marcello
M
Department of Internal Medicine, Catholic University, Rome, Italy.
Rigante
Donato
D
Marietti
Giovanni
G
Nista
Enrico C
EC
Crea
Francesca
F
Bartolozzi
Francesco
F
Schiavino
Alessandra
A
Pignataro
Giulia
G
Silveri
Nicoló Gentiloni
NG
Gasbarrini
Giovanni
G
Gasbarrini
Antonio
A
D000293:Adolescent; D000328:Adult; D000942:Antigens, Bacterial / Q000032:analysis / Q000276:immunology; D001426:Bacterial Proteins / Q000032:analysis / Q000276:immunology; D001944:Breath Tests / Q000379:methods; D002250:Carbon Radioisotopes / Q000032:analysis; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism* / Q000382:microbiology* / Q000652:urine; D005260:Female; D005767:Gastrointestinal Diseases / Q000378:metabolism* / Q000382:microbiology* / Q000652:urine; D006442:Glycated Hemoglobin / Q000378:metabolism; D006209:Halitosis / Q000378:metabolism / Q000382:microbiology / Q000652:urine; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000378:metabolism* / Q000652:urine; D016480:Helicobacter pylori / Q000302:isolation & purification; D006456:Hemoglobinuria / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014508:Urea / Q000032:analysis
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002250:Carbon Radioisotopes; D006442:Glycated Hemoglobin; D014508:Urea; C080866:cagA protein, Helicobacter pylori