Forschung & Innovation
Publikationen
Helicobacter pylori infection and insulin resistance in a screening population
PMU Autor*innen
Franz Singhartinger, Vera Paar, Michael Lichtenauer, Andreas Voelkerer, Sarah Wernly, Josef Holzinger, Mathias Ausserwinkler, Maria Flamm, Klaus Emmanuel, Elmar Aigner, Christian Datz, Bernhard Wernly
Alle Autor*innen
Franz Singhartinger, Georg Semmler, Vera Paar, Michael Lichtenauer, Andreas Voelkerer, Sarah Wernly, Josef Holzinger, Mathias Ausserwinkler, Maria Flamm, Christian Jung, Klaus Emmanuel, Elmar Aigner, Christian Datz, Bernhard Wernly
Fachzeitschrift
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
Kurzfassung
Background Helicobacter pylori (H. pylori) infection has been associated with insulin resistance and metabolic syndrome, particularly in East Asian populations. Whether these associations are independent or explained by socioeconomic and lifestyle confounding remains unclear. We examined this relationship in a large European cohort using rigorous confounder adjustment and Bayesian sensitivity analyses. Methods This cross-sectional study included 4681 asymptomatic adults (2007-2020), with H. pylori status determined by gastric biopsy. The primary outcome was insulin resistance (homeostatic model assessment for insulin resistance >2.5); secondary outcomes included HOMA2 model parameters and metabolic syndrome (Adult Treatment Panel III criteria). Poisson regression estimated incidence rate ratios (IRRs) with sequential adjustment for age, sex, education, alcohol, smoking, and diet. Bayesian analyses quantified the probability of clinically meaningful effects. Results Of 4681 participants (median age 57; 52% male), 868 (18.5%) were H. pylori-positive. Infected individuals had lower education, higher body mass index, and higher alcohol consumption. Crude insulin resistance prevalence was higher in H. pylori-positive participants (31% vs 27%; P = .015). In unadjusted regression, H. pylori was associated with insulin resistance (IRR 1.15, 95% CI 1.01-1.32), but this association disappeared after full adjustment (IRR 1.12, 95% CI 0.95-1.31; P = .176). No association with metabolic syndrome was found (IRR 1.03; P = .681). Bayesian analysis showed an 87.9% probability of practical equivalence, arguing strongly against a clinically meaningful independent effect. Conclusion The association between H. pylori and insulin resistance is fully explained by socioeconomic and lifestyle confounding. H. pylori acts as a marker of adverse metabolic risk rather than a causal factor, and eradication cannot be recommended for metabolic syndrome prevention.
Keywords
METABOLIC SYNDROME, Insulin resistance, screening, Helicobacter pylori, Helicobacter infection