title: Helicobacter pylori infection significantly increases insulin resistance in the asymptomatic Japanese population.
abstract: BACKGROUND
  Helicobacter pylori infection has been shown to contribute to atherosclerosis and cardiovascular diseases. Insulin resistance is the pathophysiologic background of the clinical features of atherosclerosis and cardiovascular diseases. We examined the association between H. pylori infection and insulin resistance in a large Japanese population.
  
  
  METHODS
  Fifteen hundred ninety-eight consecutive asymptomatic subjects that underwent a complete medical survey in our institute between May 2007 and July 2008 were recruited. Cases under medication for hypertension, hyperlipidemia, diabetes mellitus, hyperuricemia, or cardiovascular diseases were excluded from the study. Cases suffering from chronic renal or liver failure were also excluded. The homeostasis model assessment of insulin resistance (HOMA-IR) score was used to quantitatively estimate insulin resistance. Visceral and subcutaneous adipose tissues (SAT) were measured by computed tomography. The association between H. pylori serostatus and HOMA-IR score was investigated by multivariate regression analysis.
  
  
  RESULTS
  A total of 988 men and 119 women were eventually eligible for this cross-sectional survey. Helicobacter pylori seropositivity was significantly higher in 99 cases with insulin resistance (HOMA-IR >or=2.5) compared with 1008 cases without insulin resistance (HOMA-IR <2.5) (39.4 vs 28.7%, p = .027). There was a significant association between H. pylori serostatus and HOMA-IR score by multiple linear regression analysis (coefficients = 0.152, 95% CI = 0.058-0.246, p = .001), after adjusting for sex, age, body mass index, waist girth, visceral and subcutaneous adipose tissues, smoking status, alcohol consumption, dietary habits, and physical activity.
  
  
  CONCLUSIONS
  Helicobacter pylori infection significantly and independently contributed to promoting insulin resistance in a large asymptomatic population.
authors.affiliation: Center for Preventive Medicine, Kanto Medical Center, NTT East, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Gunji
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Fujibayashi
authors.forename: Mitsue
authors.initials: M
authors.lastname: Okumura
authors.forename: Noriko
authors.initials: N
authors.lastname: Sasabe
authors.forename: Akio
authors.initials: A
authors.lastname: Urabe
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D016481:Helicobacter Infections / Q000378:metabolism* / Q000382:microbiology; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D007333:Insulin Resistance; D007564:Japan; D008297:Male; D008875:Middle Aged; D055815:Young Adult