Résumé
This work was intended to study the possible association of H. pylori infection with cardiovascular disease in type 2 diabetic patients. The study included 180 subjects classified into four groups: Group I included 75 patients with both type 2 diabetes and CHD, Group II included 50 patients with type 2 diabetes, Group III included 30 patients with CHD and Group IV included 25 matched controls. All patients and controls were subjected to the following: complete history taking, thorough clinical examination and routine laboratory tests. Assessment of CHD was done by 12-lead resting electrocardiogram. H. pylori seiological status was assessed by ELISA which has a sensitivity and specificity of >/= 95%. Measurement of acute phase reactants [fibrinogen, CRP] and serum lipid profile was done. Testing for microalbuminuria was performed using micral test. H. pylori seropositivity was significantly higher both in patients with CHD [X[2] =14.97, p < 0.05], and in those with type 2 diabetes [X[2] = 6.89, p < 0.05] than in normal controls. Furthermore, H. pylori seropositivity was higher in diabetic patients with CHD than in diabetic patients without CHD [X[2]= 9.23, p< 0.05]. H. pylori seropositive subjects had significantly lower HDL-C level [t = 3.21, p < 0.05] and significantly higher plasma fibrinogen level [t = 2.76, p < 0.05] than the seronegative ones. No significant relation was found between H. pylori seropositivity and the duration of diabetes [t = 0.11, p > 0.05], fasting plasma glucose [t = 0.86, p > 0.05] or the presence of microalbuminuria [X[2]=0.74, p> 0.05]. Our results suggest that type 2 diabetes and CHD may be associated with H. pylori infection This association may be complicated by plasma fibrinogen level and /or modified serum lipid profile. In type 2 diabetic patients, the frequency of H. pylori infection is higher than in non-diabetic subjects. This could be related to the reduced gastric motility, glycosylation process in the gastric mucosa and diminished mucosal defense mechanisms