Chronic Gastritis Is Associated with a Decreased High-Density Lipid Level: Histological Features of Gastritis Based on the Updated Sydney System

Abstract

Chronic gastritis could activate a systemic inflammatory response that could result in adverse lipid profiles. To determine the severity of chronic gastritis, Helicobacter pylori (HP), mononuclear cell (lymphocytes and plasma cells), and neutrophil scores were assessed on the basis of the updated Sydney system (USS), which is widely used for histological grading. The aim of this study was to assess the relationships between gastric histological features and lipid profile levels. This study included 15,322 males and 5929 females who underwent a health checkup and gastric biopsy at the Kangbuk Samsung Medical Center (KBSMC). We analyzed whether the HP, mononuclear cell, and neutrophil grades according to the USS were related to serum leukocyte count, unhealthy behaviors, and lipid profile levels. Gastritis with HP, neutrophils, or moderate to severe mononuclear cells was associated with an elevated serum leukocyte count. A high leukocyte count was related to increased low-density lipoproteins (LDL) and triglycerides/very-low-density lipoprotein (VLDL) and decreased high-density lipoproteins (HDL). In multivariate analyses, chronic gastritis with HP or moderate to severe mononuclear cells was significantly associated with decreased HDL in males, while mononuclear cells were significantly related to decreased HDL in females. Chronic gastritis was associated with an increased systemic inflammatory response, which was associated with unfavorable lipid profiles, especially low HDL levels.

Keywords: Helicobacter; cardiovascular diseases; cholesterol; gastritis.

Figure 1

(A) Mild (score 1), moderate (score 2), and severe (score 3) Helicobacter pylori (red arrowhead) (Giemsa, original magnification ×400), mononuclear cells (hematoxylin and eosin, original magnification ×100), and neutrophils (hematoxylin and eosin, original magnification ×100) (B) The presence of Helicobacter pylori is associated with higher mononuclear cell (right) and neutrophil (left) counts than the absence of Helicobacter pylori (mononuclear cells: 1.34 and 2.02, respectively, p < 0.001; neutrophils: 0.7 and 1.99, respectively, p < 0.001).

Figure 2

(A) In the female group, the serum leukocyte count was increased in the presence of Helicobacter pylori (absence, 5.66 versus presence, 5.92 (10⁹/L)]), mononuclear cells (absence/mild, 5.65 versus moderate/severe 5.82 (10⁹/L)), and neutrophils (absence, 5.65 versus presence, 5.84 (10⁹/L)). (B) In the male group, the serum leukocyte count was increased in the presence of Helicobacter pylori (absence, 6.44 versus presence, 6.57 (10⁹/L)), mononuclear cells (absence/mild, 6.41 versus moderate severe 6.56 (10⁹/L)), and neutrophils (absence, 6.39 versus presence, 6.55 (10⁹/L)) (error bars: standard errors of the mean).

Figure 3

(A) In the female group, a high serum leukocyte count was associated with decreased high-density lipoprotein (HDL) but increased low-density lipoprotein (LDL), triglycerides and very-low-density lipoprotein (VLDL) (HDL, r = −0.134; LDL, r = 0.148; triglycerides, r = 0.238; VLDL, r = 0.238, all p < 0.001). (B) In the male group, a high serum leukocyte count was associated with decreased high-density lipoprotein (HDL) but increased low-density lipoprotein (LDL), triglycerides and very-low-density lipoprotein (VLDL) (HDL, r = - 0.139; LDL, r = 0.113; triglycerides, r = 0.204; VLDL, r = 0.204, all p < 0.001).