A study of arteriosclerosis in healthy subjects with HBV and HCV infection.

BACKGROUND: It is unclear whether infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) affects arteriosclerosis. We performed a cross-sectional study to clarify the effect of HBV and HCV infection on arteriosclerosis. METHODS: The study subjects were 1806 healthy individuals who visited Shimane Environment and Health Public Corporation for routine medical check-ups. Serum levels of total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, and blood glucose were investigated in all subjects. The degree of arteriosclerosis was assessed using systolic blood pressure, the bilateral ankle brachial index (ABI), the heart-carotid pulse wave velocity (HCPWV), and the heart-ankle PWV (HAPWV). These cardiovascular parameters were compared between control subjects and subjects with HBV and HCV infection, using analysis of covariance to adjust for confounding factors (sex, age, body mass index, and smoking and drinking). RESULTS: Of the 1806 subjects, 39 and 31 were diagnosed as positive for HBV and HCV infection, respectively. The remaining 1736 were considered to be the controls. Adjusted serum lipid levels in the subjects with HBV and those with HCV infection tended to be lower than those in the control subjects. Adjusted arteriosclerotic parameters in the subjects with HBV and HCV infection were similar to those in the control subjects, even after adjusting for serum lipid levels. CONCLUSIONS: Infection with HBV or HCV does not influence the severity of arteriosclerosis in healthy subjects.

Prevalence of endoscopically negative and positive gastroesophageal reflux disease in the Japanese.

OBJECTIVE: The frequency of gastroesophageal reflux disease (GERD) has not been fully investigated in the Asian population. The aim of this study was to investigate the prevalence of GERD, endoscopy-negative GERD (NERD), and erosive GERD in Japan, and the factors influencing disease prevalence. MATERIALS AND METHODS: A total of 2760 subjects (mean age 50.4 years, range 24-84 years) were prospectively enrolled in this multicenter study. GERD symptoms were assessed with the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST) and upper gastrointestinal endoscopy was performed on all study participants. RESULTS: A total of 495 (17.9%) individuals were diagnosed with GERD by the presence of erosive esophagitis at endoscopy and/or by the presence of GERD symptoms. Erosive esophagitis was diagnosed endoscopically in 195 (7.1%), and symptomatic GERD was diagnosed in 351 (12.7%) based on a QUEST score of over 6. Of these 351 subjects, 300 (10.9%) were considered to have NERD. Male gender, hiatal hernia, and mild gastric mucosal atrophy were significant positive predictive factors of erosive esophagitis by multiple regression analysis. Hiatal hernia ws the only significant predictor of GERD symptoms. Traditional Japanese foods, such as sweet cakes and rice cake, frequently exacerbated GERD symptoms. CONCLUSIONS: The prevalence of GERD in the Japanese was 17.9% and the prevalence rates of NERD and erosive esophagitis were 10.9% and 8.6%, respectively. The majority of symptomatic patients did not have endoscopically proven esophagitis. Hiatal hernia is the only important predictor of the presence of GERD symptoms.

Pulse-wave velocity and cardiovascular risk factors in subjects with Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori infection has been reported to correlate with the onset of cardiovascular diseases. However, the relationship between H. pylori infection and the development of arteriosclerosis has not been fully investigated. We performed a cross-sectional study to clarify the possible role of H. pylori infection in the development of arteriosclerosis. METHODS: The subjects were 996 cases who attended their annual medical check-up between April and August 2001. H. pylori infection status was determined by assaying serum anti-H. pylori immunoglobulin G antibodies. Total cholesterol, high-density lipoprotein cholesterol (HDLC), triglyceride, fasting blood glucose, hemoglobin A1c and leukocyte levels were determined. Arteriosclerotic parameters (systolic blood pressure (SBP), ankle brachial index (ABI) and pulse-wave velocity (PWV)) were measured non-invasively using an automatic device. The data for H. pylori-seropositive and -seronegative individuals were compared. RESULTS: Five hundred and seventy-three subjects (57.5%) were H. pylori-seropositive. After adjustment for sex, age, body mass index, and smoking and drinking habits, the HDLC levels of the seropositive and seronegative groups differed markedly (55.0 vs 58.0 mg/dL, P < 0.0001). Although there were no differences between the overall adjusted SBP and ABI values, the PWV was higher in H. pylori-seropositive than -seronegative young (<39 years old) individuals (heart-carotid PWV: 632.2 vs 589.7 cm/s, P = 0.027). These differences tended to disappear with aging. CONCLUSIONS: The degree of arterial stiffness in H. pylori-positive young subjects is higher than that in H. pylori-negative young subjects. However, no difference between the arterial stiffness values of H. pylori-seropositive and -seronegative elderly individuals was observed.

Comparative evaluation of urine-based and other minimally invasive methods for the diagnosis of Helicobacter pylori infection.

BACKGROUND: Diagnostic methods have recently been developed for detecting anti-Helicobacter pylori antibody in urine and H. pylori antigen in stool samples. Our aim was to evaluate the usefulness of noninvasive urine-based methods for the diagnosis of H. pylori infection. METHODS: The study subjects were 100 asymptomatic Japanese volunteers. We investigated the diagnostic efficacy of various noninvasive diagnostic methods; five serological tests (Immunis anti-pylori, HM-CAP, EIAgen Helicobacter pylori IgG, Helico G, and GAP-IgG), one test for antigen in stool (HpSA enzyme immunoassay [EIA]), and two tests for antibody in urine (Urinelisa and Rapirun) by using the urea breath test (UBT) as the gold standard. RESULTS: Fifty subjects were diagnosed as positive for H. pylori infection by the UBT. The serological tests showed good sensitivity, specificity, and accuracy. The diagnostic values of the feces-based test (HpSA EIA) were lower than that of the serological tests. The sensitivities of the two urine-based methods in frozen urine samples were markedly lower than those of the other tests. However, the use of unfrozen samples markedly improved the diagnostic accuracy of these urine-based tests, which was then superior to that of the feces-based method. CONCLUSIONS: This study clearly showed that urine-based tests were useful for the diagnosis of H. pylori infection. However, the use of frozen urine samples was not appropriate for the detection of anti-H. pyloriantibody.

Cardiovascular risk factors in subjects with Helicobacter pylori infection.

BACKGROUND: It has been proposed that Helicobacter pylori infection is related to cardiovascular disease, although this has not been fully investigated. The aim of this study was to investigate whether H. pylori infection is associated with cardiovascular risk factors. SUBJECTS AND METHODS: One thousand six hundred and fifty people undergoing annual medical checks at Shimane Institute of Health Science between September 1998 and August 1999 were enrolled. Gender, age, body mass index, habitual smoking and drinking, systolic and diastolic blood pressure, serum level of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDLC), blood glucose, leukocyte count and hemoglobin were compared between H. pylori seropositive and seronegative cases. RESULTS: In H. pylori seropositive individuals, HDLC was significantly lower than that in seronegative individuals. After adjustment for possible confounding factors (gender, age, BMI, smoking and drinking habits), mean HDLC in H. pylori-seropositive and seronegative individuals were 56.1 and 58.2 mg/dl, respectively (p <.005). The percentage of the elderly (over 50 years old) individuals with HDLC < 35 mg/dl in H. pylori seropositive and seronegative groups were 7.4% and 4.7%, respectively (p <.001). In addition, the lower HDLC level was accompanied by an increased leukocyte count. CONCLUSION: Long-term infection with H. pylori may have an important role in decreasing the serum HDLC concentration.