幽门螺杆菌感染与胰岛素抵抗替代指标的相关性

Association between Helicobacter pylori Infection and Surrogate Markers of Insulin Resistance

摘要: 目的：本研究基于美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据库，旨在探讨幽门螺杆菌(Helicobacter pylori, H. pylori)感染与胰岛素抵抗(Insulin Resistance, IR)替代指标之间的关系。方法：选取NHANES数据库1999~2000年横断面调查的参与者数据；采用单因素及多因素Logistic回归分析H. pylori感染的影响因素；通过多模型的Logistic回归分析H. pylori感染与IR替代指标的关联性，进行了亚组分析，以确保结果稳定。结果：最终纳入1446名参与者，H. pylori感染的总体患病率为41.8%，平均年龄为50.9岁。校正全部混杂因素后，甘油三酯葡萄糖(triglyceride glucose index, TyG)指数、甘油三酯葡萄糖–腰高比(triglyceride glucose-waist to height ratio, TyG-WHtR)和胰岛素抵抗代谢(metabolic score for insulin resistance, METS-IR)指数与H. pylori感染仍然呈现正相关。按年龄、性别、种族、吸烟、饮酒状况进行的亚组分析显示，无统计学显著性相互作用(P > 0.05)。结论：本研究结果表明，TyG指数、TyG-WHtR指数和METS-IR与H. pylori感染的风险有关，为未来研究提供了潜在的生物标志物。

Abstract: Objective: This study explores the relationship between Helicobacter pylori (H. pylori) infection and surrogate markers of insulin resistance (IR) using data from the National Health and Nutrition Examination Survey (NHANES) database. Methods: Data from the 1999~2000 NHANES cross-sectional survey were analyzed. Univariate and multivariate logistic regression models were used to identify factors influencing H. pylori infection. The association between H. pylori infection and IR surrogate markers was further assessed using multiple logistic regression models, with subgroup analyses conducted for robustness. Results: The study included 1446 participants, with an H. pylori infection prevalence of 41.8% and an average age of 50.9 years. After adjusting for confounders, the triglyceride glucose (TyG) index, triglyceride glucose-waist to height ratio (TyG-WHtR), and metabolic score for insulin resistance (METS-IR) index remained positively associated with H. pylori infection. Subgroup analyses by age, gender, ethnicity, smoking, and alcohol use revealed no statistically significant interactions (P > 0.05). Conclusion: These findings indicate that the TyG index, TyG-WHtR, and METS-IR are associated with an increased risk of H. pylori infection, highlighting their potential as biomarkers for further research.