成年健康体检人群幽门螺旋杆菌感染与超重/肥胖、血脂、血糖及非酒精性脂肪肝的关系研究

目的 了解安徽地区成年健康体检人群幽门螺旋杆菌（Helicobacter pylori, Hp）的感染现状，分析Hp感染与超重/肥胖、血脂、血糖及非酒精性脂肪肝（non-alcoholicfatty liverdisease, NAFLD）的关系。方法 在2020年1—12月安徽医科大学第一附属医院健康管理中心的成年健康体检人群中，选取13C/14C呼气试验、一般检查、生化及肝脏超声等体检资料齐全的33 050例为研究对象。根据呼气试验结果分为Hp阳性组和Hp阴性组。使用二元logistic回归分析Hp感染与超重/肥胖、血脂异常、高血糖、NAFLD的关系。结果 Hp感染率随着BMI的上升逐渐增高，其中肥胖（BMI＞28 kg/m2）人群Hp感染率最高。NAFLD组Hp感染率38.17%（4 570/11 972）高于非脂肪肝组36.64%（7 723/21 078），差异有统计学意义（χ2 = 7.674，P＜0.05）。Hp阳性组的BMI、TC、TG、LDL - C及空腹血糖水平高于Hp阴性组，HDL-C水平低于Hp阴性组，差异有统计学意义（t值分别为- 61.945、- 5.227、- 4.137、- 6.088、- 5.981、5.257，P＜0.05）。多因素二元logistic回归分析显示，肥胖、低HDL - C血症、高LDL - C血症、高血糖是Hp感染的危险因素，OR值分别为 1.136（95%CI:1.049～1.231）、 1.104（95%CI:1.029～1.184）、1.252（95%CI:1.083～1.448）、1.099（95%CI:1.027～1.177）。结论 成年健康体检人群幽门螺旋杆菌感染率随着BMI的增加呈上升趋势，肥胖、低HDL血症、高LDL血症、高血糖是Hp感染的危险因素。

Analysis of correlation between the helicobacter pylori infection and overweight/obesity,blood lipids,blood glucose and NAFLD among adult health examination population

Objective To investigate the infection status of Helicobacter pylori (Hp) among physical examination population in Anhui, and to explore the association between Hp infection and overweight/obesity, blood lipids, blood glucose, and non-alcoholic fatty liver disease (NAFLD). Methods From January 2020 to December 2020, 33 050 cases with complete physical examination data including 13C/14C breath test, general examination, biochemistry and liver ultrasound were selected from the adult health check-up population in the Health Management Center of the First Affiliated Hospital of Anhui Medical University. According to the results of the breath test, they were divided into Hp-positive and Hp-negative groups. The relationship between Hp infection and overweight/obesity, dyslipidemia, hyperglycemia, and NAFLD was analyzed using binary logistic regression. Results Hp infection rate increased gradually with the rise of BMI, with the highest Hp infection rate in the obese (BMI>28 kg/m2) group. 38.17% (4,570/11 972) of the NAFLD group had higher Hp infection rate than 36.64% (7 723/21 078) of the non-fatty liver group, and the difference was statistically significant (χ2=7.674, P<0.05). The BMI, TC, TG, LDL-C and fasting glucose levels were higher in the positive group than in the Hp-negative group, and HDL-C levels were lower than in the Hp-negative group, with statistically significant differences (t=-61.945, -5.227, -4.137, -6.088, -5.981, and 5.257, respectively, P<0.05). Multifactorial binary logistic regression analysis showed that obesity, low HDL-Cemia, high LDL-Cemia, and hyperglycemia were risk factors for Hp infection with ORs of 1.136 (95%CI: 1.049 to 1.231), 1.104 (95%CI: 1.029 to 1.184), 1.252 (95%CI: 1.083 to 1.448), and 1.099 (95%CI: 1.027 to 1.177). Conclusion The prevalence of Hp infection in adult health check-up population showed an increasing trend with increasing BMI, and obesity, low HDL-Cemia, high LDL-Cemia, and hyperglycemia were risk factors for Hp infection.