Prevention of the metabolic syndrome insulin resistance and the atherosclerotic diseases in Africans infected by Helicobacter pylori infection and treated by antibiotics.
OBJECTIVE
To report on the association between certain components of the metabolic syndrome/Insulin resistance, gender, cardiovascular diseases and Helicobacter (H.) pylori seropositivity/Infection and the response of these cardiovascular risk factors to Helicobacter pylori titers after an antibiotic course.


METHODS
In 205 consecutive Africans referred to the cardiovascular Center of LOMO MEDICAL in Kinshasa for management of their cardiovascular diseases, the proportions of seropositives for H. pylori and H. pylori infection (H. pylori seropositivity and histologically proven H. pylori gastritis) were investigated. The association between traditional cardiovascular risk factors, certain components of the metabolic syndrome and each H. pylori disease group (seropositivity or infection) was evaluated. The response of the cardio-metabolic level to H. pylori antibody titers after an antibiotic course was also evaluated for patients with H. pylori infection. Baseline levels of H. pylori antibody titer and cardio-metabolic parameters were compared with those after the antibiotic treatment.


RESULTS
A total of 62.4% of participants were tested positive for the H. pylori antibody. Out of all participants, 25% had H. pylori infection and chronic gastritis without H. pylori. Men were more (p<0.01) H. pylori seropositive than women. Older age, higher triglycerides, higher weight, wider waist girth, higher fibrinogenemia, greater intima-mediathighness and higher rate of hypertension were significantly associated with H. pylori seropositivity. Lower HDL-cholesterol, higher levels of systolic blood pressure, triglycerides, uric acid, fibrinogen, hematocrit, glycemia, arterial hypertension hypercholesterolemia, diabetes mellitus hypo-HDL-cholesterolemia, hyperuricemia (Total), Overweight, overall obesity, abdominal obesity were significantly associated with H. pylori infection. Within the total population, there was a significant dose-response relationship between the rates of arterial hypertension, rate of overweight/overall obesity, and H. pylori antibody titers, respectively. After adjusting for age, and compared with H. pylori-seropositive women, H. pylori-seropositive men showed higher mean values for body weight, waist girth, waist-to-hip ration blood pressure, hematocrit, uric acid, triglycerides and total cholesterol. The levels of uric acid (p<0.05), plasma glucose (p<0.01), total cholesterol (p<0.01), fibrinogen (p<0.01), blood pressure (p<0.05), after 3 weeks antibiotics duration were lower than their baseline levels; weight, waist girth and triglyceride levels did not change (p<0.05) with the antibiotics course. The total population was characterized by lower levels of triglycerides, absence of cases with triglycerides >50 mg/dL.


CONCLUSIONS
This study adds evidence for supporting the association of seropositivity to H. pylori with cardiovascular diseases and elevated number of components of metabolic syndrome. In these Africans with low triglyceride levels, H. pylori infection per se might generate atherosclerosis or metabolic syndrome, particularly in men with H. pylori-seropositive. H. pylori infection might be one of the risk factors of atherosclerosis thorough inflammation (fibrinogen) and modulation of glucose and lipid profiles, which may be prevented by low antibiotics in developing countries.
Longo-Mbenza
B
B
Department of Internal Medicine, University of Kinshasa, and Lomo Medical/Limete, Kinshasa, DR Congo. longombenza@yahoo.fr
Nkondi Nsenga
J
J
Vangu Ngoma
D
D
D000704:Analysis of Variance; D000886:Anthropometry; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
D000900:Anti-Bacterial Agents