Male non-insulin users with type 2 diabetes mellitus are predisposed to gastric corpus-predominant inflammation after <Emphasis Type="Italic">H. pylori</Emphasis> infection |
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| Authors: | Yao-Jong?Yang Chung-Tai?Wu Horng-Yih?Ou Chin-Han?Lin Hsiu-Chi?Cheng Wei-Lun?Chang Wei-Ying?Chen Hsiao-Bai?Yang Cheng-Chan?Lu Email author" target="_blank">Bor-Shyang?Sheu |
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| Institution: | 1.Departments of Pediatrics,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan;2.Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan;3.Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan;4.Institutes of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan;5.Department of Pathology,Ton-Yen General Hospital,Hsin-Chu,Taiwan;6.Department of Internal Medicine,Tainan Hospital, Ministry of Health and Welfare,Tainan,Taiwan;7.Department of Internal Medicine,National Cheng Kung University Hospital,Tainan,Taiwan |
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| Abstract: | BackgroundBoth H. pylori infection and diabetes increase the risk of gastric cancer. This study investigated whether patients with type 2 diabetes mellitus (T2DM) and H. pylori infection had more severe corpus gastric inflammation and higher prevalence of precancerous lesions than non-diabetic controls.MethodsA total of 797 patients with type 2 diabetes mellitus were screened for H. pylori, of whom 264 had H. pylori infection. Of these patients, 129 received esophagogastroduodenoscopy to obtain topographic gastric specimens for gastric histology according to the modified Updated Sydney System, corpus-predominant gastritis index (CGI), Operative Link on Gastritis Assessment, and Operative Link on Gastric Intestinal Metaplasia Assessment. Non-diabetic dyspeptic patients who had H. pylori infection confirmed by esophagogastroduodenoscopy were enrolled as controls.ResultsThe male as well as total T2DM patients had higher acute/chronic inflammatory and lymphoid follicle scores in the corpus than non-diabetic controls (p < 0.05). In contrast, the female T2DM patients had higher chronic inflammatory scores in the antrum than the controls (p < 0.05). In T2DM patients, the males had significantly higher rates of CGI than the females (p < 0.05). Multivariate logistic regression analysis showed that male patients (odds ratio: 2.28, 95% confidence interval: 1.11–4.69, p = 0.025) and non-insulin users (odds ratio: 0.33, 95% confidence interval: 0.15–0.74, p = 0.007) were independent factors for the presence of CGI in the H. pylori-infected patients with type 2 diabetes mellitus.ConclusionsPatients with type 2 diabetes mellitus and H. pylori infection had more severe corpus gastric inflammation than non-diabetic controls. Moreover, male gender and non-insulin users of T2DM patients were predisposed to have corpus-predominant gastritis after H. pylori infection.Trial registrationClinicalTrial: NCT02466919, retrospectively registered may 17, 2015. |
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