title: Helicobacter pylori and Crohn's disease: a retrospective single-center study from China.
abstract: OBJECTIVE
  To investigate the association between Helicobacter pylori (H. pylori) infection and the prevalence of Crohn's disease (CD).
  
  
  METHODS
  Subjects were selected from patients admitted the gastrointestinal (GI) department at The First Affiliated Hospital School of Medicine (Zhejiang University) for abdominal pain, hematochezia, diarrhea and other GI symptoms between January 2008 and September 2012. CD was diagnosed by endoscopy and biopsy. H. pylori infection was detected by a (14)C-urea breath test and culturing of the biopsy sample. Demographic, anthropometric and serologic data were collected for each patient. H. pylori infection rate was compared between CD and control groups, followed by a subgroup analysis based on extent and severity of CD. Student's t, Mann-Whiney U, and χ(2) tests were used to analyze the data.
  
  
  RESULTS
  A total of 447 patients were analyzed, including 229 in the CD group and 248 in the control group. There were no significant differences in age, sex, and rates of hypertension or diabetes. However, the CD group showed significantly higher rates of smoking history (34.9% vs 18.1%), alcohol intake (17.4% vs 8.1%), white blood cell count (9.7 ± 2.9 × 10(9)/L vs 4.3 ± 0.9 × 10(9)/L), and C-reactive protein (36.3 ± 20.8 mg/L vs 5.5 ± 2.3 mg/L) but lower body mass index (24.5 ± 2.0 kg/m(2) vs 26.0 ± 2.2 kg/m(2)) than the control group. The H. pylori infection rate in the CD group was 27.1%, significantly lower than that of 47.9% in the control group. Furthermore, the H. pylori infection rates in patients with colonic, small intestine, ileocolonic and extensive CD were 31.1%, 28.9%, 26.8% and 25.9% respectively, all of which were significantly lower than in the control group. Finally, the H. pylori infection rates in patients with remission, moderate and severe CD were 34.3%, 30.7% and 22.0% respectively, which were also significantly lower than in the control group.
  
  
  CONCLUSIONS
  Lower H. pylori infection in CD patients suggests a correlation between bacterial infection and CD, suggesting caution when considering H. pylori eradication in CD patients.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Zun
authors.initials: Z
authors.lastname: Xiang
authors.forename: Yi-Peng
authors.initials: YP
authors.lastname: Chen
authors.forename: Yue-Fang
authors.initials: YF
authors.lastname: Ye
authors.forename: Kui-Fen
authors.initials: KF
authors.lastname: Ma
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Zheng
authors.forename: Yi-Da
authors.initials: YD
authors.lastname: Yang
authors.forename: Xi
authors.initials: X
authors.lastname: Jin
mesh_terms: D000328:Adult; D001706:Biopsy; D001944:Breath Tests; D016009:Chi-Square Distribution; D002681:China; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D012720:Severity of Illness Index
keywords: Bacteria; Biopsy; Crohn’s disease; Helicobacter pylori; Inflammatory bowel disease; Pathogenesis; Urea breath test
references.citation: Dig Dis Sci. 2004 Sep;49(9):1425-32
references.pmid: 15481314
references.citation: Scand J Gastroenterol. 1997 Jul;32(7):712-8
references.pmid: 9246713
references.citation: Science. 2003 Mar 7;299(5612):1582-5
references.pmid: 12624269
references.citation: Infect Immun. 1997 Nov;65(11):4858-64
references.pmid: 9353076
references.citation: Lancet. 2007 Oct 20;370(9596):1453-7
references.pmid: 18064739
references.citation: J Clin Microbiol. 2004 Feb;42(2):874-6
references.pmid: 14766877
references.citation: Inflamm Bowel Dis. 2006 Oct;12(10):1008-9
references.pmid: 17012975
references.citation: Gut. 2011 Nov;60(11):1580-8
references.pmid: 21252204
references.citation: Helicobacter. 2006 Feb;11(1):2-9
references.pmid: 16423084
references.citation: Gastroenterol Clin North Am. 2002 Mar;31(1):41-62
references.pmid: 12122743
references.citation: Med J Aust. 1989 Oct 16;151(8):435-9
references.pmid: 2593958
references.citation: J Dig Dis. 2011 Feb;12(1):45-50
references.pmid: 21276208
references.citation: J Dig Dis. 2008 Feb;9(1):52-62
references.pmid: 18251795
references.citation: Helicobacter. 2005 Jun;10(3):223-30
references.pmid: 15904480
references.citation: Nat Clin Pract Gastroenterol Hepatol. 2005 Sep;2(9):406-15
references.pmid: 16265431
references.citation: Lancet. 1984 Jun 16;1(8390):1311-5
references.pmid: 6145023
references.citation: J Gastroenterol. 2010;45(1):9-16
references.pmid: 19960355
references.citation: Infect Immun. 1998 Nov;66(11):5157-66
references.pmid: 9784517
references.citation: Gastroenterology. 2002 May;122(5):1346-54
references.pmid: 11984521
references.citation: Helicobacter. 2004 Jun;9(3):278-83
references.pmid: 15165265
references.citation: Curr Gastroenterol Rep. 2011 Oct;13(5):465-74
references.pmid: 21792543
references.citation: Genes Immun. 2005 Dec;6(8):637-45
references.pmid: 16107869
references.citation: Gut. 1998 Nov;43 Suppl 3:S7-12
references.pmid: 10083867
references.citation: Inflamm Bowel Dis. 2010 Jun;16(6):1077-84
references.pmid: 19760778
references.citation: FEMS Immunol Med Microbiol. 2011 Feb;61(1):1-14
references.pmid: 20955468
references.citation: J Gastroenterol Hepatol. 2006 Dec;21(12):1772-82
references.pmid: 17074013
references.citation: Aliment Pharmacol Ther. 2004 Mar 1;19(5):613-4
references.pmid: 14987330
references.citation: Gut. 2007 Jul;56(7):934-40
references.pmid: 17145736
references.citation: J Dig Dis. 2010 Jun;11(3):134-47
references.pmid: 20579217
references.citation: Am J Gastroenterol. 2007 Aug;102(8):1808-25
references.pmid: 17608775
references.citation: N Engl J Med. 2002 Feb 21;346(8):614-6
references.pmid: 11856802
references.citation: Inflamm Bowel Dis. 2006 Apr;12(4):304-10
references.pmid: 16633052
references.citation: Inflamm Bowel Dis. 2011 Feb;17(2):639-44
references.pmid: 20725944
references.citation: Nat Rev Gastroenterol Hepatol. 2011 Jun;8(6):299
references.pmid: 21643027
references.citation: JAAPA. 2011 May;24(5):37-40
references.pmid: 21574530
references.citation: World J Gastroenterol. 2012 Apr 21;18(15):1723-31
references.pmid: 22553396
references.citation: Clin Microbiol Rev. 2007 Apr;20(2):280-322
references.pmid: 17428887
references.citation: J Clin Microbiol. 2004 Jun;42(6):2766-8
references.pmid: 15184464
references.citation: Rev Med Chil. 2006 Jan;134(1):95-100
references.pmid: 16532169
references.citation: Intern Med. 2004 Jul;43(7):534-9
references.pmid: 15335176
references.citation: Aliment Pharmacol Ther. 2003 Sep 1;18(5):481-6
references.pmid: 12950420
references.citation: FEMS Microbiol Rev. 2006 Jan;30(1):131-56
references.pmid: 16438683
references.citation: Nature. 2007 Feb 22;445(7130):915-918
references.pmid: 17287725