Analysis of the associations among Helicobacter pylori infection, adiponectin, leptin, and 10-year fracture risk using the fracture risk assessment tool: A cross-sectional community-based study

Abstract

Helicobacter pylori (H. pylori) infection may induce inflammatory cytokines or adipokines that influence bone turnover and bone fracture risk. This study aimed to evaluate the association among H. pylori infection, adipokines, and 10-year fracture risk using the Fracture Risk Assessment Tool scale. From August 2013 to February 2016, a community-based cohort was surveyed by Keelung Chang-Gung Memorial Hospital. Subjects were included if they were older than 40 years and not pregnant. All participants underwent a standardized questionnaire survey, physical examination, urea breath test, and blood tests. A total of 2,689 participants (1,792 women) were included in this cross-sectional study. In both sexes, participants with a high fracture risk were older and had higher adiponectin values than participants without a high fracture risk (mean age, female: 72.9 ± 5.6 vs. 55.8 ± 7.3 years, P < 0.0001; male: 78.9 ± 4.7 vs. 58.1 ± 8.9 years, P < 0.001) (adiponectin, female: 10.8 ± 6.3 vs. 8.7 ± 5.2 ng/ml, P < 0.001; male: 9.7 ± 6.1 vs. 5.5 ± 3.8 ng/ml, P < 0.001). Adiponectin was correlated with high fracture risk in both sexes, but H. pylori infection and leptin was not. In logistic regression analysis, adiponectin could not predict high fracture risk when adjusting the factor of body mass index (BMI) in men group. In conclusion, H. pylori infection and leptin could not predict 10-year fracture risk in either sex. Adiponectin was correlated with bone fracture risk in both sexes and the correlation might be from the influence of BMI.

Fig 1. A flow diagram of participants.

There were five participants with chronic obstructive pulmonary disease (COPD) and two participants with rheumatoid arthritis (RA). Three participants with COPD and 1 with rheumatoid arthritis who took steroid for disease control. Two participants with COPD took PPI for chronic cough possibly related to gastroesophageal reflux disease (GERD). Another one patient with RA did not take steroid.

Fig 2. Lifetime bone fracture risk by the FRAX hip fracture probability (%) in participants with or without H. pylori infection.

The numbers on the X-axis indicate the age interval (every 5 years) from 40 to 90 years old. The numbers on the Y-axis indicate the 10-year hip bone fracture probability (%) by FRAX. There was no significant difference in mean hip fracture probability (%) between participants with and without H. pylori infection in both sexes.

Fig 3. Mean values of adiponectin and leptin in participants with or without H. pylori infection.

The numbers on the X-axis indicate the age interval (every 5 years) from 40 to 90 years old. The numbers on Y-axis axis indicate the serum concentrations of adiponectin (μg/ml) and leptin (ng/ml). The mean serum adiponectin values increased with increased ages of participants. The mean adiponectin and leptin values were higher in women than in men. There was no significant difference in mean adiponectin and leptin values between participants with and without H. pylori infection in any age period.