Correlation between Helicobacter pylori infection and homocysteine levels and cerebral small vessel disease / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To study the relationship between Helicobacter pylori (HP) infection and homocysteine (Hcy) levels and cerebral small vessel disease (CSVD).Methods:From March 2017 to December 2018, 67 patients (outpatient and inpatient) who complained of dizziness in the First Affiliated Hospital of Jinzhou Medical University were divided into CSVD group(30 cases) and control group(37 cases). Single factor analysis, Spearman correlation analysis and binary logistic regression analysis were used to analyze the influencing factors of CSVD.Receiver operating characteristic curve was used to predict the diagnostic value of influencing factors for CSVD.The effects of HP and Hcy on CSVD were analyzed using mediation effect.Results:(1)Hcy ( r=0.345, P=0.004), HP positive ( r=0.274, P=0.026), age ( r=0.420, P=0.000), male ( r=0.260, P=0.034), total cholesterol ( r=0.273, P=0.025), triglycerides ( r=0.272, P=0.026), hypertension ( r=0.454, P=0.000), diabetes ( r=0.284, P=0.020), smoking ( r=0.499, P=0.000), coronary heart disease ( r=0.284, P=0.020) were positively correlated with CSVD.(2)Logistic regression analysis showed that Hcy ( β=0.315, OR=1.370, 95% CI=1.025-1.831), total cholesterol ( β=0.979, OR=2.661, 95% CI=1.086-6.523) were independent risk factors for CSVD.(3)Hcy (sensitivity 76.7%, specificity 86.5%)and total cholesterol levels(sensitivity 90.0%, specificity 83.8%) had specific and sensitive diagnostic value for the diagnosis of CSVD, and total cholesterol (area under ROC curve=0.928) had more diagnostic value than Hcy (area under ROC curve=0.877). (4) The mediating effect of HP on CSVD was not completely affected by the mediating effect of Hcy, and HP had partially direct effect on CSVD. Conclusions:(1) Hcy and total cholesterol are independent risk factors of CSVD, which have specific and sensitive diagnostic value for CSVD, especially for total cholesterol.(2)The mediating effect of HP on CSVD is not completely affected by the mediating variable Hcy, and HP has a partially direct effect on CSVD.