Helicobacter pylori infection may increase the risk of dyslipidemia in asymptomatic patients without dyslipidemia at baseline; however, successful eradication of H pylori infection might reduce the risk of dyslipidemia, according to the results of a study published in Helicobacter.
A group of investigators from the Samsung Medical Center, Seoul, South Korea, conducted a large, retrospective cohort study from January 2009 to December 2018 to assess whether a longitudinal link exists between H pylori infection and the risk of developing dyslipidemia. This study included analysis of data from 2626 healthy participants without dyslipidemia at baseline who took part in a regular health-screening examination that included upper gastrointestinal endoscopy. Primary outcome was the incidence of dyslipidemia at follow-up, and the secondary outcome was the development of abnormal lipid parameters at follow-up.
Over the 10,324 participant-years of follow-up, the researchers found a higher incidence of dyslipidemia in participants with persistent H pylori infection (130.5 per 1000 person-years) compared with those whose infections were successfully controlled (98.1 per 1000 person-years). The H pylori eradication group was found to have a lower risk of dyslipidemia compared with the group with persistent H pylori infection (HR, 0.85; 95% CI, 0.77-0.95; P=.004) in a multivariable model adjusted for age, sex, waist circumference, smoking status, alcohol intake, and education level. In addition, the link continued after further adjustment for baseline levels of low-density as well as high-density lipoprotein cholesterol (HR, 0.87; 95% CI, 0.79-0.97; P=.014).
This study had several limitations, including its retrospective research design and the difficulties associated with generalizing these findings to other populations due to a focus on healthy adults. Possible inaccuracies in the histologic diagnosis of H pylori infection, unawareness of study objectives by endoscopists and pathologists, and the possibility of residual confounders such as dietary factors and physical activity were also limitations of the study.
The study authors concluded, “These findings support the hypothesis that H. pylori contributes to the pathogenesis of dyslipidemia, and its eradication can reduce the risk of dyslipidemia.” They added, “The benefit of H. pylori eradication was observed not only in the reduction of gastric malignancy, peptic ulcer disease, and idiopathic thrombocytopenic purpura but also in the decrease of the probability of dyslipidemia.”
Park Y, Kim TJ, Lee H, et al. Eradication of Helicobacter pylori infection decreases risk for dyslipidemia: a cohort study. Helicobacter. Published online January 28, 2021. doi:10.1111/hel.12783