Gastric Helicobacter pylori infection is associated with adverse metabolic traits in severely obese subjects

OBJECTIVE: Asian studies have reported on an association of Helicobacter pylori (Hp) infection with insulin resistance (IR) in normal-weight subjects. Whether such an association likewise exists in European subjects with severe obesity was questioned.

DESIGN AND METHODS: To address this question, 370 severely obese patients from our database were identified, who had undergone a gastroscopy with a histological examination of gastric mucosal biopsies and a concurrent assessment metabolic blood parameters as a standard examination before bariatric surgery.

RESULTS: Seventy-five (20.3%) of the subjects displayed a histologically proven Hp infection (Hp+). Sex distribution, age, and body mass index of Hp+ subjects did not differ from that of the subjects with no Hp infection (Hp-; all P > 0.293), but Hp+ subjects were significantly smaller (P = 0.006). Fasting glucose, insulin, high-sensitive C reactive protein, and alanine aminotransferase levels as well as calculated indices of IR (i.e., HOMA-IR, QUICKI) did not differ between Hp+ and Hp- subjects (all P > 0.42). However, Hp+ subjects showed significantly higher triglyceride levels and a higher total chloesterol-to-HDL ratio but lower sex-hormone binding globulin (SHGB) levels than Hp- subjects (all P ≤ 0.05).

CONCLUSION: While our results obtained in European severely obese patients do not provide evidence for an enhanced IR state associated with gastric Hp infection, they suggest that the presence of the bacterium in gastric biopsies is associated with an adverse lipid profile and reduced SHGB levels.