Data from: The role of morbidly obesity in the promotion of metabolic disruptions and non-alcoholic steatohepatitis by Helicobacter Pylori

Helicobacter pylori (HP) infection has been associated to an increased rate of type 2 diabetes (T2D) and liver disease through its effect on insulin resistance and systemic inflammation. However, results are inconstant and no studies exist in morbidly obese patients, in which both insulin resistance and inflammation coexist. Material and Methods: Cross-sectional study to evaluate the relationship between HP infection and alterations in carbohydrate metabolism, lipid profile, inflammation markers, and liver disease in patients awaiting for bariatric surgery. HP infection was histologically assessed in gastric antrum biopsy from 416 subjects. Liver biopsy was also available in 93 subjects. Results: Both impaired fasting glucose and T2D were similar when comparing subjects with and without HP infection (24.2% vs. 22%, p=0.290 and 29.4% vs. 29.1%, p=0.916, respectively), with no differences between groups in the HOMA-IR, lipid profile neither inflammatory parameters. However, HP infection was higher among subjects with a BMI ? 40.0 kg/m2 in comparison with lower degrees of obesity (71.7% vs. 60.0%, p=0.041). In addition, subjects without HP infection showed higher degrees of steatosis (44.1±26.4% vs. 32.0±20.7%, p=0.038), as well as a lower prevalence of non-alcoholic steatohepatitis (9.3% vs. 30.7%, p=0.023). Conclusions: In patients with morbid obesity, HP infection does not seem to be associated with abnormal carbohydrate metabolism. In addition, less advanced degrees of non-alcoholic fatty disease were observed. We suggest that low-grade inflammation that accompanies obesity mitigates the diabetogenic effect of HP, so the presence of obesity should be considered in studies that evaluate the HP metabolic effects.

幽门螺杆菌（Helicobacter pylori, HP）感染可通过影响胰岛素抵抗与全身炎症反应，与2型糖尿病（type 2 diabetes, T2D）及肝脏疾病的发病率升高相关。然而现有研究结果并不一致，且尚未有针对病态肥胖患者的相关研究——此类患者同时存在胰岛素抵抗与慢性炎症状态。
材料与方法：本研究为横断面研究，旨在评估拟接受减重手术患者的幽门螺杆菌感染与糖代谢异常、血脂谱异常、炎症标志物水平及肝脏疾病之间的关联。研究对416名受试者的胃窦活检标本进行组织学幽门螺杆菌感染评估，其中93名受试者同时提供了肝脏活检标本。
结果：对比幽门螺杆菌阳性与阴性受试者，空腹血糖受损与2型糖尿病的患病率均无显著统计学差异（分别为24.2% vs 22%，p=0.290；29.4% vs 29.1%，p=0.916）；两组间稳态模型胰岛素抵抗指数（HOMA-IR）、血脂谱及炎症参数均无统计学差异。然而，BMI≥40.0 kg/m²的受试者中幽门螺杆菌感染率显著高于肥胖程度更低的受试者（71.7% vs 60.0%，p=0.041）。此外，幽门螺杆菌阴性受试者的肝脂肪变程度更高（44.1±26.4% vs 32.0±20.7%，p=0.038），且非酒精性脂肪性肝炎患病率更低（9.3% vs 30.7%，p=0.023）。
结论：在病态肥胖患者中，幽门螺杆菌感染似乎与糖代谢异常无关联；同时，此类患者的非酒精性脂肪性肝病进展程度更轻。本研究提示，肥胖伴随的低度炎症反应可抵消幽门螺杆菌的致糖尿病效应，因此在评估幽门螺杆菌代谢相关影响的研究中，应将肥胖状态纳入考量变量。