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Long-term Effect of Helicobacter pylori Eradication on Risk Factors for Cardiovascular Disease - Is there a
Katja Tepes1, Sitke Aygen2, Gorazd Avgustin3
1Department of Gastroenterology, Diagnostic Center Rogaška, Rogaška Slatina; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. katja.tepes@gmail.com.
Insights
Eradicating Helicobacter pylori infection improved lipid profiles and slightly reduced TMAO levels, suggesting a link between H. pylori and cardiovascular disease risk factors. This study explored long-term effects on CVD risk markers.
Area of Science:
- Cardiology
- Gastroenterology
- Microbiology
Background:
- Cardiovascular disease (CVD) is a leading global cause of death.
- Chronic inflammation plays a role in CVD pathogenesis.
- Helicobacter pylori (H. pylori) infection is a potential contributor to CVD risk.
Purpose of the Study:
- To investigate the long-term effects of successful H. pylori eradication on cardiovascular disease risk factors.
- To assess changes in insulin resistance, lipid profiles, and TMAO levels post-eradication.
Main Methods:
- Seventy-two patients were randomized into two H. pylori eradication regimens.
- Outcomes included HOMA-IR, lipid profiles, and urinary TMAO.
- Assessments were conducted at baseline, two months, and one year after eradication.
Main Results:
- Successful H. pylori eradication led to significant reductions in total cholesterol, LDL cholesterol, and small dense lipoprotein particles.
- A marginal decrease in urinary TMAO concentrations was observed.
- No significant changes were found in BMI, waist circumference, or HOMA-IR.
Conclusions:
- H. pylori eradication is associated with improved lipid metabolism.
- A marginal reduction in TMAO levels suggests H. pylori may influence systemic inflammation.
- These findings indicate H. pylori's potential role in CVD risk through lipoprotein modulation.
Background And Aims:
Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Beyond traditional risk factors, chronic inflammation is increasingly recognized in its pathogenesis. Helicobacter pylori (H. pylori) infection has been proposed as a potential contributor. This study aimed to investigate the long-term effects of successful H. pylori eradication on selected CVD risk factors.
Methods:
Seventy-two patients were enrolled between July 2020 and November 2022 and randomized to two 14-day regimens (group 1: esomeprazole, amoxicillin, clarithromycin; group 2: esomeprazole, amoxicillin, metronidazole, colloidal bismuth subcitrate). Outcomes included homeostatic model assessment of insulin resistance (HOMA-IR) index, lipid profiles and subfractions, and urinary trimethylamine N-oxide (TMAO), assessed by nuclear magnetic resonance spectroscopy. Assessments were performed at baseline, two months, and one year after confirmed H. pylori eradication.
Results:
Of the 72 enrolled patients, 13.9% (10/72) were lost to follow-up. Baseline CVD risk factors did not differ significantly between groups. After successful eradication, both groups demonstrated significant reductions in total cholesterol (p=0.003), low-density lipoprotein cholesterol (p=0.010), small dense lipoprotein particles (p=0.037), and marginal decrease in TMAO concentrations (p=0.048). No significant changes were observed in body mass index (p=0.799), waist circumference (p=0.305), or HOMA-IR index (p=0.275).
Conclusions:
Successful eradication of H. pylori infection was associated with favorable changes in lipid metabolism and marginal decrease in TMAO levels. These findings suggest that H. pylori may contribute to CVD risk by modulating lipoprotein profiles and systemic inflammation.
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