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Published on: November 1, 2024
Association between Helicobacter pylori infection and carotid atherosclerosis in Chinese adults
Li Du1,2, Jianghong Liu3, Cheng Jin4,5
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Helicobacter pylori infection is linked to carotid atherosclerosis in Chinese adults. Preventing H. pylori may help reduce the risk of developing carotid plaques.
Area of Science:
- Cardiovascular Health
- Infectious Diseases
- Epidemiology
Background:
- The association between Helicobacter pylori (H. pylori) infection and carotid atherosclerosis is debated.
- Previous studies have yielded inconsistent findings regarding this link.
Purpose of the Study:
- To investigate the association between H. pylori infection and the incidence of carotid atherosclerotic plaques.
- To analyze this association in a large cohort of Chinese adults without pre-existing cardiovascular disease.
Main Methods:
- 108,210 Chinese adults underwent carotid ultrasound and H. pylori testing (13C-urea breath test).
- 93,915 participants without baseline cardiovascular disease or carotid plaques were analyzed.
- Cox proportional hazard models and meta-analyses were used to assess the risk (Hazard Ratio) of developing carotid plaques.
Main Results:
- H. pylori infection was associated with a higher likelihood of developing carotid plaques.
- The adjusted Hazard Ratio for carotid plaque onset in H. pylori-infected individuals was 1.04 (95% CI: 1.01-1.08).
- Results remained robust after adjusting for numerous sociodemographic, clinical, and lifestyle factors.
Conclusions:
- H. pylori infection is significantly associated with the onset of carotid plaques in Chinese adults.
- These findings suggest that H. pylori infection is a potential risk factor for carotid atherosclerosis.
- Preventing H. pylori infection could be a strategy to mitigate the burden of carotid atherosclerosis.
Background And Aims:
The role of Helicobacter pylori (H. pylori) infection in carotid atherosclerosis remains inconsistent and sometimes controversial. We aimed to determine whether H. pylori infection is associated with carotid atherosclerotic plaques in a large number of Chinese adults.
Methods:
We recruited 108,210 Chinese adults who participated in a standard medical screening with both carotid ultrasonic examination and 13C-urea breath test for H.pylori infection from two Chinese cohorts. A total of 93,915 adults were included in the analysis after excluding participants with cardiovascular disease (CVD) and carotid plaques at baseline. Hazard ratio (HR) for developing carotid plaques by H. pylori infection was analyzed using the Cox proportional hazard model, with sociodemographic and clinical factors adjusted. Findings across cohorts were pooled by meta-analyses.
Results:
11,208 (13.13%) participants occurred carotid plaques at a median follow-up of 20 months in the MN cohort, while 1279 (14.95%) participants occurred carotid plaques at a median follow-up of 24 months in the MJ cohort. Compare with participants without H. pylori infection, participants with H. pylori infection were more likely to occur carotid plaques. After adjusting for age, sex, annual personal income, body mass index, blood pressure, blood glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and estimated glomerular filtration rate, the HR was 1.04 (95%CI: 1.01-1.08). After further adjusting for education level, marital status, smoking status, alcohol drinking status, physical activity, and family history of CVD, the HR changed minimally. Additional sensitivity analyses confirmed the robustness of the results. Significant interactions of age, sex, blood pressure, blood glucose, or chronic inflammation were not observed in this research.
Conclusions:
H. pylori infection was associated with carotid plaque onset in a large number of Chinese adults without previous CVD. These data suggested that the prevention of H. pylori infection may reduce the burden of carotid atherosclerosis.
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