title: Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients.
abstract: BACKGROUND
  Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients.
  
  
  METHODS
  In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index.
  
  
  RESULTS
  The mean age of participants was 54±10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24±0.23 μg/mL and 9.9±9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (γ=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; γ=0.43, P<0.01), and triglycerides/HDL-C ratio (γ=-0.28, P<0.05) were observed.
  
  
  CONCLUSIONS
  Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.
authors.affiliation: Nutrition and Endocrine Research Center and Obesity Research Center, Research Institute for Endocrine Sciences, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bahadoran
authors.affiliation: Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Tehran, Iran. mirmiran@endocrine.ac.ir.
authors.forename: Parvin
authors.initials: P
authors.lastname: Mirmiran
authors.affiliation: Nutrition and Endocrine Research Center and Obesity Research Center, Research Institute for Endocrine Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zarif-Yeaganeh
authors.affiliation: Research Center for Gastroenterology and Liver Disease, Department of Gastroenterology and Liver Diseases, Tehran, Iran.
authors.forename: Homayoun
authors.initials: H
authors.lastname: Zojaji
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
keywords: Cardiometabolic risk factors; Diabetes mellitus, type 2; Gastric inflammation; Helicobacter pylori infection; Pepsinogens