title: Association between Helicobacter pylori and mortality in the NHANES III study.
abstract: OBJECTIVE
  Persistent colonisation by Helicobacter pylori, and especially by cagA-positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality.
  
  
  METHODS
  We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of H pylori status with all-cause and cause-specific mortality. Analyses for the association of H pylori cagA positivity with mortality were conducted in 7384 subjects with data on H pylori cagA status.
  
  
  RESULTS
  In older people (> 40.1 years), H pylori was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of H pylori status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for H pylori cagA positivity, with the HR of 0.45 (95% CI 0.27 to 0.76). H pylori was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini-Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and H pylori status was not related to other outcomes.
  
  
  CONCLUSIONS
  Our findings suggest that H pylori has a mixed role in human health, but is not a major risk factor for all-cause mortality.
authors.affiliation: Department of Population Health, New York University School of Medicine, , New York, NY 10016, USA. yu.chen@nyumc.org
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Stephanie
authors.initials: S
authors.lastname: Segers
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000942:Antigens, Bacterial / Q000032:analysis; D002423:Cause of Death; D002648:Child; D015331:Cohort Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology / Q000401:mortality*; D020521:Stroke / Q000209:etiology / Q000401:mortality*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D000942:Antigens, Bacterial
keywords: Cardiovascular Disease; Epidemiology; Gastric Cancer; Helicobacter Pylori; Pancreatic Cancer