[Helicobacter pylori infection and its metabolic consequences in children and adolescents with type 1 diabetes mellitus].
Helicobacter pylori infection (Hp) is the cause of chronic gastritis and duodenitis, ulcer disease, and functional gastrointestinal motor disorders. Its prevalence among Polish children with type 1 diabetes mellitus has been estimated at 25%. There is limited data regarding the influence of Helicobacter pylori infection on clinical course of diabetes, with controversial results.


OBJECTIVE
of the study was the estimation of Helicobacter pylori infection on the quality of metabolic control in children and adolescents with type 1 diabetes mellitus.


METHODS
198 diabetic patients were investigated (mean age 14.38+/-3.75; range 4.5-25 years), with diabetes duration of 4.91+/-4.21 years (range 0.5-16 years). Screening for Helicobacter pylori infection was performed utilizing the urea breath test (UBTC13); DOB (delta over the baseline) above 3%o was considered positive. Metabolic control included HbA1c (HPLC; Bio-Rad, Munich, Germany) and glucose concentration measurement; glycemia was expressed as area under the curve in fasting and prandial state (AUC).


RESULTS
UBT was positive in 48 (24.3%) diabetic patients. HbA1c concentration was significantly higher in patients with Helicobacter pylori infection (7.87+/-1.51 vs. 7.17+/-1.46%; p<0.05). The AUC values were higher in Hp positive diabetic subjects: AUCO 83.75+/-40.99 vs. 66.82+/-31.71 and AUC1 189.86+/-61.57 vs. 149.02+/-51.66 [mg% x 0.5h x 0.5]; p<0.05.


CONCLUSIONS
1. Helicobacter pylori infection significantly worsens metabolic control in children and adolescents with type 1 diabetes mellitus. 2. High prevalence of Helicobacter pylori infection among young diabetic subjects and its influence on glucose control legitimate the screening for Hp inpatients with poor metabolic control of diabetes.
Toporowska-Kowalska
Ewa
E
Klinika Alergologii, Gastroenterologii i Zywienia Dzieci III Katedry Pediatrii UM, ul. Sporna 36/50, 91-738 Lodz, Poland.
Wasowska-Królikowska
Krystyna
K
Szadkowska
Agnieszka
A
Bodalski
Jerzy
J
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001944:Breath Tests / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000378:metabolism* / Q000382:microbiology; D004382:Duodenitis / Q000453:epidemiology / Q000378:metabolism; D004415:Dyspepsia / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000378:metabolism* / Q000382:microbiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D010437:Peptic Ulcer / Q000453:epidemiology; D015995:Prevalence; D012016:Reference Values
D001786:Blood Glucose; D006442:Glycated Hemoglobin