Extragastric manifestations of Helicobacter Pylori infection in Romanian population

Abstract

Introduction: Helicobacter pylori (H. pylori) is one of the most frequent causes of gastrointestinal infections worldwide. It is known that the immunological response evoked by the bacterium is an important determinant of gastric mucosal damage. Epidemiological studies have investigated H. Pylori as a pathogenic determinant of some extragastric disorders due tolow-grade inflammatory state, molecular mimicry mechanisms, interference with the absorbance of nutrients and drugs possibly influencing the occurrence or the evolution of many diseases. The main burden of infection is in the developing countries possibly reflecting the presence of geographical variability in the prevalence of both H. pylori infection and the considered extradigestive disorders. Purpose and objectives: The aim of this study is to determine the prevalence of systemic hypertension (HTA), ischemic cardiomyopathy (IC), dyslipidemia, type 2 diabetes mellitus (T2DM) and chronic obstructive pulmonary disease (COPD) in a series of patients with Helicobacter Pylori infection and explore the possible etiopathogenetic link between them. Materials and method: A total of 100 participants were divided into two groups according to the presence (n=45) or absence (n=55) of Helicobacter Pylori infection. The detection of bacteria was assessed by upper endoscopic gastric biopsies. The presence of HTA, IC, dyslipidemia, T2DM and COPD were investigated in the medical history of both groups. Results: One hundred patients (47 men, 53 women), aged 30-85 years (the mean 58.1) were included; 55% of patients were positive for H. pylori infection. Twenty-two (51%) of patients with H. Pylori infection presented HTA, compared to 24 (42%) subjects of H. Pylori negative, without semnificative difference between the two groups. (p=0.65). The presence of IC was significantly higher (46%) in H. Pylori positive group than (25%) of the group without infection (p=0.003). Nineteen patients (34%) H. pylori positive had T2DM, while 10 patients (23%) were found in the H. Pylori negative group, the difference being statistically insignificant (p=0.58). The most frequent extragastric manifestation for patients infected with H. Pylori was dyslipidemia (29.7%). The patients with H. Pylori had significantly higher levels of dyslipidemia (62%) compared with the non-infected group (25%) (p=0.002). Sixteen (25%) cases of COPD were found in H. Pylori positive group and 10 (26%) in the H. Pylori negative group without reaching statistically significant levels (p=0.71). Conclusion: The association between H. pylori infection and ischemic cardiomyopathy and dyslipidemia was revealed in this study. Although some authors found convincing evidence of the involvement of Helicobacter pylori as one possible cause of systemic hypertension, type 2 diabetes mellitus and chronic obstructive pulmonary disease, our results have failed to confirm the existence of this etiological association. Hence, the precise processes remain unclear and require further studies.