title: Helicobacter pylori infection increases the risk of adult-onset asthma: a nationwide cohort study.
abstract: Helicobacter pylori infection (HPI) appears to reduce risk of childhood-onset asthma, but the relationship between HPI and adult-onset asthma is inconclusive. This study explored the potential association between HPI and risk of adult-onset asthma. We conducted a national insurance retrospective cohort study using the longitudinal health insurance database (LHID 2000) in Taiwan. We enrolled the HPI group consisting of 1664 patients with HPI diagnosis between 2000 and 2007, and the non-HPI group consisting of 6,656 age- and sex-matched subjects without HPI. All study participants had been followed up from index date to the diagnostic date of asthma, withdrawal from the National Health Insurance program, or the end of 2011, which came first. We analyzed risk of adult-onset asthma with respect to sex, age, and comorbidities by using Cox models. Cigarette smoking status, which could not be obtained from the program, was adjusted indirectly by considering chronic obstructive pulmonary diseases in our statistical models because the disease is related to heavy smoking. After adjustment for sex, age, and comorbidities, HPI was significantly associated with an increased 1.38-fold risk of adult-onset asthma. Moreover, among people without comorbidities, the 1.85-fold risk of adult-onset asthma remained higher for the HPI population compared with the non-HPI population. In this study, patients with HPI exhibited a significantly higher risk of adult-onset asthma than did the subjects without HPI.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: T-Y
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Department of Internal Medicine, Armed Forces Tao-Yuan General Hospital, Tao-Yuan City, Taiwan.
authors.forename: S-T
authors.initials: ST
authors.lastname: Shang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.|Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
authors.affiliation: Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Medical Research, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. yang_t_y@yahoo.com.tw.|Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan. yang_t_y@yahoo.com.tw.
authors.forename: T-Y
authors.identifier: http://orcid.org/0000-0002-3165-132X
authors.initials: TY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive; D055815:Young Adult
keywords: Allergic Conjunctivitis; Asthma; Chronic Obstructive Pulmonary Disease; National Health Insurance Program; National Health Insurance Research Database