title: Impact of Helicobacter pylori Immunoglobulin G Levels and Atrophic Gastritis Status on Risk of Metabolic Syndrome.
abstract: BACKGROUND
  Helicobacter pylori (HP) infection is implicated in gastric and extra-gastric diseases. While gastritis-related chronic inflammation represents a known trigger of metabolic disturbances, whether metabolic syndrome (MetS) is affected by gastritis status remains unclear. We aimed to clarify the effect of HP-related gastritis on the risk of MetS.
  
  
  METHODS
  We retrospectively enrolled patients undergoing screening for MetS between 2014 and 2015. Investigations included HP-specific immunoglobulin G (IgG) antibody assays to detect HP infection, and serum pepsinogen assays to evaluate atrophic gastritis status. The risk of MetS was evaluated via multiple logistic regression analyses with two covariates: serum HP infection status (IgG levels) and atrophic gastritis status (two criteria were applied; pepsinogen I/II ratio < 3 or both pepsinogen I levels ≤ 70 μg/L and pepsinogen I/II ratio < 3).
  
  
  RESULTS
  Of 1,044 participants, 247 (23.7%) were HP seropositive, and 62 (6.0%) had MetS. HP seronegative and seropositive patients had similar risks of MetS. On the other hand, AG (defined in terms of serum PG I/II <3) was significant risk of MetS (OR of 2.52 [95% CI 1.05-7.52]). After stratification according to HP IgG concentration, patients with low HP infection status had the lowest MetS risk (defined as an odds ratio [OR] adjusted for age, sex, smoking, drinking and physical activity status). Taking this result as a reference, patients with negative, moderate, and high HP infection status had ORs (with 95% confidence intervals [CI]) of 2.15 (1.06-4.16), 3.69 (1.12-16.7), and 4.05 (1.05-26.8).
  
  
  CONCLUSIONS
  HP-associated gastritis represents a risk factor for MetS. Research should determine why low and not negative HP infection status is associated with the lowest MetS risk.
authors.affiliation: Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeoka
authors.affiliation: Graduate School of Education, Nagasaki University, Nagasaki, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Tayama
authors.affiliation: Department of Endocrinology and Metabolism, Sasebo City General Hospital, Sasebo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamasaki
authors.affiliation: Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Saigo
authors.affiliation: Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hayashida
authors.affiliation: Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Shirabe
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D016001:Confidence Intervals; D005260:Female; D005757:Gastritis, Atrophic / Q000097:blood* / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D020115:Pepsinogen C; D020116:Pepsinogen A