[1]吴梦杰,刘倩,岳樊林.幽门螺杆菌感染对代谢综合征患者胰岛素抵抗和脂蛋白亚组分的影响及性别差异研究[J].陕西医学杂志,2025,54(9):1197-1202.[doi:DOI:10.3969/j.issn.1000-7377.2025.09.007]
　WU Mengjie,LIU Qian,YUE Fanlin.Effects of helicobacter pylori infection on insulin resistance and lipoprotein subcomponents in patients with metabolic syndrome and gender differences[J].,2025,54(9):1197-1202.[doi:DOI:10.3969/j.issn.1000-7377.2025.09.007]
点击复制

幽门螺杆菌感染对代谢综合征患者胰岛素抵抗和脂蛋白亚组分的影响及性别差异研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年9期
页码:
1197-1202
栏目:
临床研究
出版日期:
2025-09-05

文章信息/Info

Title:
Effects of helicobacter pylori infection on insulin resistance and lipoprotein subcomponents in patients with metabolic syndrome and gender differences
作者:
吴梦杰1; 刘倩2; 岳樊林1
（1.华中科技大学同济医学院附属协和医院体检科，湖北 武汉 430056；2.华中科技大学同济医学院附属协和医院感染管理科，湖北 武汉 430056）
Author(s):
WU Mengjie1; LIU Qian2; YUE Fanlin1
(1.Department of Physical Examination,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China;2.Department of Infection Management,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China)
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
Keywords:
Metabolic syndrome; Helicobacter pylori; Insulin resistance; Lipoprotein subcomponents; Gender differences; Correlation
分类号:
R 589
DOI:
DOI:10.3969/j.issn.1000-7377.2025.09.007
文献标志码:
A
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。
Abstract:
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.

参考文献/References:

[1]刘早玲,唐溢乐,苏津,等.代谢综合征患者糖化白蛋白及糖化血红蛋白比值与全因死亡率的关系[J].现代预防医学,2024,51(23):4225-4230.
[2]岳悦,郑桂玲,褚月颉,等.四逆散合平胃散联合罗格列酮治疗代谢综合征疗效及对患者氧自由基水平的影响[J].陕西中医,2022,43(4):479-482.
[3]张玉红,宋凤莲,陈勇.利司那肽联合贝那普利对代谢综合征患者血糖血压、肠道微生态、靶器官损害的影响[J].临床误诊误治,2023,36(10):96-100.
[4]GONZLEZ GONZLEZ J G,VIOLANTE CUMPA J R,ZAMBRANO LUCIO M,et al.HOMA-IR as a predictor of health outcomes in patients with metabolic risk factors:A systematic review and meta-analysis[J].High Blood Press Cardiovasc Prev,2022,29(6):547-564.
[5]武凯璐,温爱纯,王晓静,等.2型糖尿病合并代谢综合征患者健康问题解决类型研究[J].护理学杂志,2024,39(23):8-13.
[6]SCARPIGNATO C,HUNT R H.Potassium-competitive acid blockers:Current clinical use and future developments[J].Curr Gastroenterol Rep,2024,26(11):273-293.
[7]中国医师协会中西医结合医师分会内分泌与代谢病学专业委员会.代谢综合征病证结合诊疗指南[J].世界中医药,2023,18(22):3157-3166.
[8]GARRIDO TORRES N,ROCHA GONZALEZ I,ALAMEDA L,et al.Metabolic syndrome in antipsychotic-nave patients with first-episode psychosis:A systematic review and meta-analysis[J].Psychol Med,2021,51(14):2307-2320.
[9]张琳,郭珊岚,康乐平.胃癌组织MutS同源物6、减数分裂后分离增强基因2表达与幽门螺杆菌感染及预后相关性研究[J].陕西医学杂志,2025,54(3):408-412.
[10]BELLADELLI F,MONTORSI F,MARTINI A.Metabolic syndrome,obesity and cancer risk[J].Curr Opin Urol,2022,32(6):594-597.
[11]KOUNTOURAS J,ZAVOS C,VARDAKA E,et al.Helicobacter pylori and metabolic syndrome-related adipokines in nonalcoholic fatty liver disease pathophysiology[J].J Gastroenterol Hepatol,2024,39(9):1957-1959.
[12]高佳敏,王涛,朱云峰,等.尿酸/高密度脂蛋白胆固醇比值对2型糖尿病合并非酒精性脂肪性肝病的预测价值[J].陕西医学杂志,2025,54(3):323-327.
[13]黄蕾,周锋.胰岛素抵抗代谢评分与缺血性脑卒中的研究进展[J].陕西医学杂志,2025,54(1):142-145.
[14]KOUNTOURAS J,PAPAEFTHYMIOU A,POLYZOS S A,et al.Potential impact of helicobacter pylori-related metabolic syndrome on arterial hypertension outcomes[J].Am J Hypertens,2023,36(4):192-194.
[15]KOUNTOURAS J,DOULBERIS M,POLYZOS S A,et al.Impact of helicobacter pylori-related metabolic syndrome with hyperhomocysteinemia on extragastric pathologies[J].J Gastroenterol Hepatol,2022,37(2):407-408.
[16]董佳鑫,王海艳,喀麦隆,等.幽门螺杆菌感染致表皮生长因子及其受体表达上调与胃癌发生及发展机制关系研究进展[J].陕西医学杂志,2024,53(6):853-857.
[17]钟爽,罗慧,施智兰,等.胆汁酸、幽门螺旋杆菌等因素诱导尾型同源盒转录因子2表达致胃黏膜肠上皮化生研究进展[J].陕西医学杂志,2023,52(6):771-774.
[18]XIAO Q Y,WANG R L,WU H J,et al.Effect of helicobacter pylori infection on glucose metabolism,lipid metabolism and inflammatory cytokines in nonalcoholic fatty liver disease patients[J].J Multidiscip Healthc,2024,17:1127-1135.
[19]张家祥,周永学,闫曙光,等.缺氧诱导的线粒体自噬与糖代谢重编程对胃癌前病变影响的研究进展[J].中国癌症杂志,2022,32(10):1007-1015.
[20]张晓玲,黄莹芝.2型糖尿病患者血清C1q/肿瘤坏死因子相关蛋白12水平与颈动脉粥样硬化相关性的研究[J].中国糖尿病杂志,2025,33(2):109-113.
[21]BABEL R A,DANDEKAR M P.A review on cellular and molecular mechanisms linked to the development of diabetes complications[J].Curr Diabetes Rev,2021,17(4):457-473.
[22]安冬,翟艳会,高艳奎,等.大黄黄连泻心汤及其加减方改善2型糖尿病研究进展[J].中国实验方剂学杂志,2024,30(24):141-151.
[23]吕永乐,郑雯,王签慧,等.抗代谢相关脂肪性肝病的天然活性物质研究进展[J].畜牧兽医学报,2025,56(1):45-62.
[24]曾佳玲,蒙艳,邓婷婷,等.2型糖尿病患者非酒精性脂肪肝与内脏脂肪面积及甲状腺结节的相关性研究[J].中国全科医学,2025,28(9):1072-1083.
[25]陈京京,陈盈玲,单浩杰,等.2型糖尿病患者连续血糖监测目标范围内时间与血清骨钙素N端中分子片段、Ⅰ型前胶原氨基端前肽相关性研究[J].陕西医学杂志,2025,54(3):319-327.
[26]ARON WISNEWSKY J,WARMBRUNN M V,NIEUWDORP M,et al.Metabolism and metabolic disorders and the microbiome:The intestinal microbiota associated with obesity,lipid metabolism,and metabolic health-pathophysiology and therapeutic strategies[J].Gastroenterology,2021,160(2):573-599.

相似文献/References:

[1]黎林果 ,吴宗英 ,刘华柱.四联HP根除治疗对十二指肠溃疡患者胃排空功能〖JZ〗及HSP60、TNFα的影响[J].陕西医学杂志,2019,(9):1209.
[2]卜 爱,杜 姗△.艾司奥美拉唑镁肠溶片治疗幽门螺杆菌相关性胃溃疡临床研究*[J].陕西医学杂志,2019,(10):1381.
[3]蔡 博,田 蕾△.地衣芽孢杆菌联合铋剂四联疗法根除幽门螺杆菌感染临床研究[J].陕西医学杂志,2020,49(8):1032.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.030]
[4]许东升,危一飞,蒋科卫,等.代谢综合征通过脂肪-炎症-凝血轴对全膝关节置换术围手术期的影响[J].陕西医学杂志,2025,54(12):1628.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.007]
　XU Dongsheng,WEI Yifei,JIANG Kewei,et al.Impact of MetS on perioperative period of TKA through adipose-inflammation-coagulation axis[J].,2025,54(9):1628.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.007]

备注/Memo

备注/Memo:
湖北省自然科学基金资助项目（2022CDB297）
更新日期/Last Update: 2025-09-04