Helicobacter pylori and hepatitis A virus infections and the cardiovascular risk profile in patients with diabetes mellitus: results of a population-based study.

OBJECTIVE

The objective of this study was to investigate the associations of sero-positivity for Helicobacter pylori (HP) and hepatitis A virus infection (HAV) with prevalence of cardiovascular diseases (CVD) and CVD-risk markers in a large population-based sample of patients with diabetes mellitus (DM), who are at high risk of developing CVD.

BACKGROUND

Several studies have suggested that chronic infections are associated with the development of atherosclerosis and coronary heart diseases (CHD).

METHODS

This analysis is based on the German National Health Interview and Examination Survey which was conducted in 1998. We identified all subjects with prevalent DM aged 40-79 years. Helicobacter pylori and HAV status were measured by serum immunoglobulin G antibodies. Prevalence of several CVD events (myocardial infarction, stroke and CHD) was recorded. In addition, serum levels of total triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and lipoprotein (a) were measured.

RESULTS

Among the 4285 participants of the German Health Survey aged 40-79 years, we identified 365 patients with DM. Of these, 32.1% had at least one CVD and there was a clear increase of CVD with age. Sero-prevalence of HP or HAV and their combination was not associated with the prevalence of CVD nor with mean levels of blood lipids after multivariate adjustment for covariates.

CONCLUSIONS

In this large group of 365 patients with diabetes mellitus no association of HP and HAV sero-prevalence with presence of CVDs or the level of serum lipids was established. Therefore it seems unlikely that HP and HAV sero-prevalence strongly influence CVD progression in patients with diabetes.