2017 -- Conference report inside the country
劉彥伶、盧豐華、楊宜青、王如雪、張秦松、吳晉祥、張智仁：成人胃部幽門桿菌感染與高動脈硬度之相關性比低動脈硬度之相關性為高 台灣家庭醫學醫學會106年度學術研討會會刊 P244-245.
Yen-Ling Liu, Feng-Hwa Lu, Yi-Ching Yang, Ru-Hsueh Wang, Chin-sung Chang, Jin-Shang Wu, Chih-Jen Chang: Gastric Helicobacter Pylori Infection Is More Associated with Higher Arterial Stiffness than Lower Arterial Stiffness in a Taiwanese Population
Previous studies have suggested that many pathogens, such as Chlamydia pneumonia, Cytomegalovirus, Hepatitis B and C, Herpes simplex virus and Helicobacter pylori, might influence cardiovascular diseases. But the relationship between H pylori and atherosclerosis remain controversial. Furthermore, the diagnoses of H pylori infection were made with serology tests in previous studies. The diagnostic value of endoscopic histology in diagnosing H pylori infection is higher than serology tests. The aim of this study was to investigate the association of gastric H pylori infection and arterial stiffness using pathological evidences of H pylori infection and baPWV level as measures of arterial stiffness.
This cross-sectional study included 8543 subjects aged ≥18 years old who underwent esophagogastroduodenoscopy and gastric biopsy during health examinations at National Cheng Kung University Hospital from October 2006 to August 2009. Exclusion criteria were those with age < 18 years old, past history and medications of heart disease or stroke, hypertension or dyslipidemia, and incomplete data of gastric H pylori infection. The final analysis included 1983 participants. Participants were to rest in the supine position for 5 mins. Then, a noninvasive vascular screening device (BP-203RPE II; Colin Medical Technology, Komaki, Japan) with four pneumatic pressure cuffs were used to measure baPWV for arterial stiffness over bilateral brachial arteries and posterior tibial arteries. We divided subjects into four groups based on the quartiles of baPWV (Q1: <1211.0 cm/s, Q2: 1211.0 -1348.0 cm/s, Q3: 1348.0 -1518.8 cm/s, Q4 ≥ 1518.8 cm/s). Esophagogastroduodenoscopy was performed by experienced gastroenterologists using LUCERA gastroscopes (GIF-XQ260, Olympus, Tokyo, Japan). H. pylori infection was defined as H. pylori present in the biopsy of gastric tissue.
Results: The prevalence of H pylori infection were 35.3%, 38.6%, 43.1% and 43.3% in subjects with Q1, Q2, Q3 and Q4 of baPWV (p=0.087). Multinomial logistic regression analysis was used to examine the independent relationship between gastric H pylori infection and the quartiles of baPWV. Gastric H pylori infection was positively associated with Q4 vs Q1 (OR 1.546, 95% CI 1.065-2.243, p=0.022) and Q3 vs Q1 (OR 1.394, 95% CI 1.027-1.892, p=0.033) of baPWV, but not Q2 vs Q1 (OR 1.086, 95% CI 0.812-1.452, p=0.578) of baPWV. In addition, age and hypertension were related to all three of the higher quartiles (Q2, Q3, Q4) of baPWV. Body mass index (BMI) and fasting glucose were associated with the highest quartile (Q4) of baPWV. Triglyceride level was related to both Quartile 4 and Quartile 3 of baPWV.
Gastric Helicobacter pylori infection is associated with high arterial stiffness with baPWV ≥1348.0 cm/s. However, there was an insignificant relationship between gastric H pylori infection and lower arterial stiffness with baPWV < 1348.0 cm/s.