Investigation on the prevalence of Helicobacter pylori infection and the incidence of gastric mucosal lesions in type 2 diabetes mellitus and diabetic kidney disease patients with dyspepsia symptoms / 中国基层医药

ABSTRACT

Objective To investigate the prevalence of Helicobacter pylori infection and the incidence of gastric mucosal lesions in type 2 diabetes mellitus(DM)and diabetic kidney disease(DKD)patients with dyspepsia symptoms.Methods A total of 241 type 2 diabetic patients and 69 non -diabetic subjects with dyspeptic symptoms were enrolled in the study.Gastroduodenal lesions were observed by gastrointestinal endoscopy and the presence of Helicobacter pylori infection was identified by rapid urease test and serum IgG antibodies to Helicobacter pylori.Urine albumin excretion rate(UAE)at 24 hours was measured in all subjects.According to the urinary albumin excretion rate,patients were classified into diabetes mellitus group(DMgroup,with UAE 300mg/24h).Estimated glomerular filtration rate were above 60mL·min -1 ·(1.73m2 )-1 in the three groups of patients.The 69 cases of non -diabetic subjects were used as the control group.Results The prevalence of H pylori infection in the DKD group[145 /72(62.5%)]and the DKD group 2[34 /53(64.15%)]were significantly higher than those in the control group[28 /65(43.1%)](χ2 =3.901,P =0.04;χ2 =4.223,P =0.03)and the DM group [27 /63 (42.9%)](χ2 =4.104,P =0.04;χ2 =5.116,P =0.03).No significant differences of H.pylori prevalence were detected between the DKD groups(χ2 =1.304,P =0.29)as well as the DMgroup and the control group (χ2 =0.723,P =0.40).Gastroscopy results showed that the incidence of normal endoscopic performance in the DMgroup was higher than that of the control group(57.1% vs.38.5%,χ2 =4.612,P =0.03).There were no significant differences between the control group and DM group,DKD1 group and DKD2 group in the incidence of gastric mucosal lesions (Superficial gastritisχ2 =1.206,0.912,0.707;erosive gastritisχ2 =1.422,1.836 0.870;duodenal ulcerχ2 =243.1, 1.716,2.233;gastric ulcerχ2 =1.440,0.971,1.322 and esophagitisχ2 =2.116,2.318,2.488,all P >0.05). Conclusion Diabetic nephropathy patients are more susceptible to Helicobacter pylori infection.There is no significant difference in the infection rate of Helicobacter pylori between type 2 diabetic nephropathy with microalbuminuria and with macroalbuminuria.There are no significant differences in the type of gastric mucosal lesion between Type 2 diabetes mellitus,diabetic nephropathy patients and non diabetic patients.