摘要
目的:探讨幽门螺杆菌(HP)感染对代谢综合征(MS)患者胰岛素抵抗(IR)和脂蛋白亚组分的影响及其性别差异。方法:采用横断面研究纳入MS患者417例,根据HP感染状态分为感染组(HP阳性,213例)与非感染组(HP阴性,204例)。收集MS患者一般临床资料,检测HP、脂代谢指标、血常规及脂蛋白亚组分,比较两组不同性别MS患者IR指标及脂蛋白亚组分,对不同性别MS患者IR指标及脂蛋白亚组分进行相关性分析,并采用限制性立方样条回归分析HP感染与MS发病风险的剂量-反应关系。结果:两组性别、脂代谢指标及血常规参数比较差异有统计学意义(均P<0.05)。感染组不同性别MS患者胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、空腹血糖(FPG)、小而密低密度脂蛋白(sdLDL)、高密度脂蛋白2(HDL2)、高密度脂蛋白3(HDL3)比较差异有统计学意义(均P<0.05)。感染组患者HOMA-I、FPG、FINS水平与sdLDL呈正相关,与HDL2、HDL3呈负相关(均P<0.05);未校正混杂因素前,sdLDL、HDL2、HDL3与HOMA-IR、FINS、FPG存在相关性,调整其他影响因素后相关性依然存在(均P<0.05)。男性、女性MS患者HOMA-IR、FINS、FPG水平与HP感染呈正相关(均P<0.05)。随着HP水平升高,男性MS发病风险增加更明显,而女性MS发病风险先缓慢增加后基本保持稳定。结论:HP感染显著影响MS患者IR及脂蛋白亚组分,且存在性别差异。
Objective:To explore the effects of Helicobacter pylori(HP)infection on insulin resistance(IR)and lipoprotein subfractions in patients with metabolic syndrome(MS)and gender differences.Methods:A cross-sectional study was conducted to include 417 MS patients.The patients were divided into the infection group(HP positive,213 cases)and the non-infection group(HP negative,204 cases)based on their HP infection status.General clinical data of the MS patients were collected,and HP,lipid metabolism indicators,blood routine,and lipoprotein subcomponents were tested.The IR indicators and lipoprotein subcomponents of MS patients of different genders in both groups were compared.Correlation analysis was conducted on the IR indicators and lipoprotein subcomponents of MS patients of different genders.The dose-response relationship between HP infection and the risk of MS onset was analyzed using restricted cubic spline regression.Results:There were statistically significant differences in gender,lipid metabolism indicators,and blood routine parameters between the two groups(all P<0.05).In the infected group,there were statistically significant differences in insulin resistance index(HOMA-IR),fasting insulin(FINS),fasting blood glucose(FPG),small dense low-density lipoprotein(sdLDL),high-density lipoprotein 2(HDL2),and high-density lipoprotein 3(HDL3)among patients of different genders(all P<0.05).The levels of HOMA-IR,FPG,and FINS in the infected group were positively correlated with sdLDL,and negatively correlated with HDL2 and HDL3(all P<0.05).Before adjusting for confounding factors,sdLDL,HDL2,and HDL3 were correlated with HOMA-IR,FINS,and FPG,and the correlation still existed after adjusting for other influencing factors(all P<0.05).The levels of HOMA-IR,FINS,and FPG in male and female MS patients were positively correlated with HP infection(all P<0.05).As the HP level increased,the risk of male MS onset increased more significantly,while the risk of female MS onset increased slowly and then remained basically stable.Conclusion:HP infection significantly affects IR and lipoprotein subcomponents in MS patients,and there are gender differences.
作者
吴梦杰
刘倩
岳樊林
WU Mengjie;LIU Qian;YUE Fanlin(Department of Physical Examination,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China;Department of Infection Management,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China)
出处
《陕西医学杂志》
2025年第9期1197-1202,共6页
Shaanxi Medical Journal
基金
湖北省自然科学基金资助项目(2022CDB297)。
关键词
代谢综合征
幽门螺杆菌
胰岛素抵抗
脂蛋白亚组分
性别差异
相关性
Metabolic syndrome
Helicobacter pylori
Insulin resistance
Lipoprotein subcomponents
Gender differences
Correlation
