幽门螺杆菌感染与代谢综合征的横断面研究

陈媛媛; 胡志强; 胡景岑; 吴雅娴; 马铮; 吕筠; 孙点剑一; 满塞丽麦; 王晓娜; 王波; 余灿清; 李立明

doi:10.16462/j.cnki.zhjbkz.2024.03.015

幽门螺杆菌感染与代谢综合征的横断面研究

doi: 10.16462/j.cnki.zhjbkz.2024.03.015

陈媛媛¹,
胡志强²,
胡景岑¹,
吴雅娴¹,
马铮^{3, 5},
吕筠^{1, 3, 4, 5},
孙点剑一^{1, 3, 4, 5},
满塞丽麦^{1, 5, 6},
王晓娜⁷,
王波^{3, 5, 6, ,},
余灿清^{1, 3, 4, 5, ,},
李立明^{1, 3, 4, 5}

1.
北京大学公共卫生学院流行病与卫生统计学系，北京 100191
2.
北京大学肿瘤医院暨北京市肿瘤防治研究所流行病学研究室，恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142
3.
北京大学公众健康与重大疫情防控战略研究中心，北京 100191
4.
重大疾病流行病学教育部重点实验室(北京大学)，北京 100191
5.
北京大学医学部美年公众健康研究院，北京 100191
6.
中关村美年健康产业研究院，北京 100191
7.
北京美兆健康体检中心，北京 100006

基金项目:

国家自然科学基金 82192900

国家自然科学基金 82192901

国家自然科学基金 82192904

详细信息

通讯作者:
余灿清，E-mail：yucanqing@pku.edu.cn

王波，E-mail：paul@meinianresearch.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-04
- 修回日期: 2024-01-06
- 网络出版日期: 2024-04-08
- 刊出日期: 2024-03-10

A cross-sectional study of Helicobacter pylori infection and metabolic syndrome

CHEN Yuanyuan¹,
HU Zhiqiang²,
HU Jingcen¹,
WU Yaxian¹,
MA Zheng^{3, 5},
LYU Jun^{1, 3, 4, 5},
SUN Dianjianyi^{1, 3, 4, 5},
MAN Sailimai^{1, 5, 6},
WANG Xiaona⁷,
WANG Bo^{3, 5, 6
, ,},
YU Canqing^{1, 3, 4, 5
, ,},
LI Liming^{1, 3, 4, 5}

1.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
2.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142, China
3.
Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing 100191, China
4.
Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
5.
Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China
6.
Meinian Institute of Health, Beijing 100191, China
7.
Beijing MJ Health Screening Center, Beijing 100006, China

Funds:

National Natural Science Foundation of China 82192900

National Natural Science Foundation of China 82192901

National Natural Science Foundation of China 82192904

More Information

Corresponding author: WANG Bo, E-mail: paul@meinianresearch.com; YU Canqing, E-mail: yucanqing@pku.edu.cn

摘要

摘要: 目的探究幽门螺杆菌感染与代谢综合征(metabolic syndrome, MetS)的横断面关联，为早期预防提供参考依据。方法利用北京美兆健康体检中心2009―2020年年龄≥18岁人群的体检资料，其中幽门螺杆菌感染情况由¹³C-尿素呼气试验检测，代谢综合征及其4个组成部分(腹型肥胖、高血糖、血压升高和血脂异常)的诊断参照《中国成人血脂异常防治指南》的定义，采取横断面调查设计，应用多变量logistic回归分析模型探究幽门螺杆菌感染与MetS及其4个组成部分的关联。结果共纳入31 369名体检对象，年龄为(45.3±11.6)岁，其中男性占58.7%。幽门螺杆菌阳性检出率为35.7%，MetS患病率为25.6%，其中男性MetS患病率高于女性。在调整了社会人口学、生活方式、高血压和糖尿病家族史等潜在混杂因素后，幽门螺杆菌感染者患代谢综合征(OR=1.18, 95% CI: 1.11~1.25, P<0.001)及其4个组分的风险更高，其中腹型肥胖(OR=1.18, 95% CI: 1.11~1.24, P<0.001)、血脂异常(OR=1.14, 95% CI: 1.06~1.22, P<0.001)的关联强度较高，且女性中血脂异常的关联强度高于男性(P=0.003)。结论我国成人幽门螺杆菌感染与高MetS及其组成部分的患病风险有关。
- 幽门螺杆菌 /
- 代谢综合征 /
- 横断面研究
Abstract: Objective To understand the cross-sectional association of Helicobacter pylori (H. pylori) infection with metabolic syndrome (MetS) and its four components among residents with health checkups in Beijing. Methods Participants aged 18 or older who attended health checkups at Beijing MJ Health Screening Center during 2009-2020 were included. The H. pylori infection status was identified by the ¹³C-urea breath test. The diagnoses of MetS and its four components (abdominal obesity, hyperglycemia, high blood pressure, and dyslipidemia) were defined according to the Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Multivariate logistic regression was performed to estimate the OR and 95% CI. Results Among the 31 369 participants, 58.7% were men, and the mean age was (45.3±11.6) years. The H. pylori-positive rate was 35.7%, and the prevalence rate of MetS was 25.6%. The overall prevalence of MetS in males was higher than in females. After adjusting for potential confounders, participants infected with H. pylori had elevated risks of MetS (OR=1.18, 95% CI: 1.11-1.25, P<0.001) and its four components. The ORs for abdominal obesity (OR=1.18, 95% CI: 1.11-1.24, P<0.001) and dyslipidemia (OR=1.14, 95% CI: 1.06-1.22, P<0.001) were higher. The association for dyslipidemia was stronger among females than males (P=0.003). Conclusions H. pylori infection is remarkably correlated with increased risks of MetS and its components after adjusting for potential confounders.
- Helicobacter pylori /
- Metabolic syndrome /
- Cross-sectional study

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图 1 男、女性代谢综合征及其4个组分的患病率

Figure 1. Prevalence rate of metabolic syndrome and its four components by gender

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表 1 不同幽门螺杆菌感染状态的体检对象的基本特征

Table 1. Characteristics of participants according to Helicobacter pylori infection status in MJHSC Database

特征Characteristic	幽门螺杆菌感染状态 ^① Helicobacter pylori infection status ^①		t/χ²/Z值value	P值value
特征Characteristic	阴性Negative	阳性Positive	t/χ²/Z值value	P值value
人数Number of participants	20 177	11 192
年龄/岁Age/years	45.0±11.7	45.9±11.4	6.9	<0.001
已婚Married	17 426(86.4)	9 972(89.1)	48.7	<0.001
大学及以上College and above	17 846(88.4)	9 452(84.5)	101.7	<0.001
年收入/元Annual income/yuan			5.5	<0.001
<100 000	6 992(34.7)	4 285(38.3)
100 000~199 999	6 116(30.3)	3 180(28.4)
≥200 000	7 069(35.0)	3 727(33.3)
吸烟Smoking			143.5	<0.001
从不Never	14 293(70.8)	7 222(64.5)
戒烟Former smoker	1 270(6.3)	753(6.7)
吸烟Current drinker	4 614(22.9)	3 217(28.7)
饮酒Drinking			141.0	<0.001
从不Never	14 240(70.6)	7 171(64.1)
戒酒Former drinker	634(3.1)	412(3.7)
饮酒Current drinker	5 303(26.3)	3 609(32.2)
膳食/(单位·周^-1) Diet/(unit·week^-1)
蔬菜Vegetable	2.0(2.0, 3.5)	2.0(2.0, 3.5)	3.2	0.001
水果Fruit	2.0(0.0, 2.0)	2.0(0.0, 2.0)	9.0	<0.001
肉类Meat	5.0(2.0, 7.0)	5.0(2.0, 7.0)	-1.2	0.232
油炸食品Fried food	0.0(0.0, 2.0)	0.0(0.0, 2.0)	-1.1	0.278
体力活动/[MET-(h·d^-1)] Physical activity/[MET-(h·d^-1)]	28.2±37.9	29.6±39.7	2.9	0.004
高血压家族史Family history of hypertension	7 927(39.3)	4 165(37.2)	13.1	<0.001
糖尿病家族史Family history of diabetes	5 016(24.9)	2 623(23.4)	7.9	0.005
注：①以人数(占比/%)、x±s、M(P₂₅，P₇₅)表示。 Note: ①Number of people (proportion/%) or x±s or M(P₂₅，P₇₅).

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表 2 幽门螺杆菌感染与代谢综合征及4个组分的横断面关联

Table 2. Cross-sectional associations between Helicobacter pylori infection and metabolic syndrome, as well as its four components

变量Variable	患病人数(患病率/%)Number of case(prevalence/%)		粗模型Crude model		模型1Model 1		模型2Model 2		模型3Model 3
变量Variable	幽门螺杆菌H. pylori (-)	幽门螺杆菌H. pylori (+)	OR值value(95% CI)	P值value	OR值value(95% CI)	P值value	OR值value(95% CI)	P值value	OR值value(95% CI)	P值value
代谢综合征Metabolic syndrome	4 769(23.64)	3 252(29.06)	1.32(1.26~1.39)	<0.001	1.22(1.15~1.29)	<0.001	1.19(1.13~1.26)	<0.001	1.18(1.11~1.25)	<0.001
腹型肥胖Abdominal obesity	6 451(31.97)	4 281(38.25)	1.32(1.26~1.38)	<0.001	1.22(1.16~1.28)	<0.001	1.19(1.13~1.25)	<0.001	1.18(1.11~1.24)	<0.001
高血糖Hyperglycemia	6 043(29.95)	3 786(33.83)	1.20(1.14~1.26)	<0.001	1.10(1.04~1.16)	<0.001	1.08(1.02~1.14)	0.006	1.07(1.01~1.13)	0.022
血压升高High blood pressure	6 214(30.80)	3 832(34.24)	1.17(1.11~1.23)	<0.001	1.07(1.02~1.13)	0.008	1.06(1.00~1.12)	0.036	1.07(1.01~1.13)	0.019
血脂异常Dyslipidemia	2 466(12.22)	1 682(15.03)	1.27(1.19~1.36)	<0.001	1.18(1.10~1.26)	<0.001	1.15(1.08~1.24)	<0.001	1.14(1.06~1.22)	<0.001

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