Association of helicobacter pylori infection with cardiovascular disease in type 2 diabetic patients

ABSTRACT

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