Analysis between Helicobacter pylori infection and hepatobiliary diseases

Abstract

Objective: Helicobacter pylori (H. pylori) represents a significant chronic health concern, affecting approximately half of the global population. While H. pylori infection has been closely linked to numerous extradigestive diseases, the relationship between H. pylori and lesions in the gallbladder and biliary tract remains under debate.

Method: We retrospectively collected data from patients who underwent H. pylori tests at the Physical Examination Center of Taizhou Central Hospital (Taizhou University Hospital) between 2018 and 2022. Logistic regression analysis and restricted cubic spline analysis were employed to investigate the correlation between parameters and H. pylori. Additionally, we utilized population data from the National Health and Nutrition Examination Survey (NHANES) database as an external validation cohort.

Results: A total of 30,612 patients were included in the training set, with 22,296 (72.8%) belonging to the H. pylori non-infection group and 8,316 (27.2%) to the H. pylori infection group. Compared to the non-infection group, patients in the infection group exhibited a significant decrease in albumin levels and a notable increase in total cholesterol and erythrocyte sedimentation rate levels. Furthermore, the infection group demonstrated significantly higher occurrences of gallbladder cholesterol crystals (6.0%), gallbladder polyps (20.2%), and atherosclerosis (25.6%) compared to the non-infection group, with respective rates of 5.1%, 19.1%, and 21.4% (average p < 0.05). However, no significant differences were observed between the two groups in terms of fatty liver, intrahepatic inflammation, gallstones, or cholecystitis. Additional regression analysis revealed that H. pylori, age, BMI, albumin, and total cholesterol were independent risk factors for the cholesterol crystals and atherosclerosis.

Conclusion: H. pylori infection is closely associated with the gallbladder cholesterol crystals and atherosclerosis, albeit not with conditions such as fatty liver, gallbladder stones, or cholecystitis. Future research necessitates multi-center, prospective studies to corroborate these findings.

Keywords: Helicobacter pylori; cholesterol crystal; fatty liver; gallbladder polyp; gallstone.

Figure 1

Flowchart of the physical examination population and NHANES population.

Figure 2

(A–F) RCS curves for clinical parameters and the OR value of H. pylori infection in the total population. ALB, albumin; TC, total cholesterol; GLU, glucose; ESR, erythrocyte sedimentation rate.

Figure 3

(A–F) The discrepancy in the association between clinical parameters and H. pylori infection risk among diabetic and non-diabetic individuals. ALB, albumin; TC, total cholesterol; GLU, glucose; ESR, erythrocyte sedimentation rate.

Figure 4

(A–F) RCS curves for clinical parameters and the OR value of H. pylori infection in the non-diabetic population. ALB, albumin; TC, total cholesterol; ESR, erythrocyte sedimentation rate; HbA1c, glycosylated hemoglobin.

Figure 5

Assessment of the fit and value of the logistic regression equation model. (A-C), ROC curves, calibration curve, and DCA for the model of Gallbladder Cholesterol Crystal in the total population. (D-F), ROC curves, calibration curve, and DCA for the model of Atherosclerosis in the total population. ROC, receiver operating characteristic curve; DCA, decision curve analysis (DCA).

Figure 6

(A–F) RCS curves for clinical parameters and the OR value of H. pylori infection in the NHANES population. ALB, albumin; TC, total cholesterol; GLU, glucose; ESR, erythrocyte sedimentation rate; CRP, C reactive protein.