Evaluation of the relationship between atherosclerosis and Helicobacter pylori infection with measurement of growth differentiation factor 15 and atherosclerosis indicators in adults with no comorbidity

Osman Başpinar , Ayça Elibol , Derya Koçer , Turgut Tursem Tokmak , Serkan Doğan , Oğuzhan Sıtkı Dizdar
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Abstract

Background

The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with Helicobacter pylori (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels.

Materials and methods

This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c).

Results

The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (p  0.001). There was a significant correlation between serum GDF-15 level and CIMT (r = 0.445; p  0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (p < 0.001). Vitamin B12 and D levels were comparable among groups.

Conclusion

This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.

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通过测量无合并症成年人的生长分化因子 15 和动脉粥样硬化指标,评估动脉粥样硬化与幽门螺旋杆菌感染之间的关系
背景本研究旨在通过测量幽门螺杆菌(HP)患者的颈动脉内膜中层厚度(CIMT)来调查亚临床动脉粥样硬化的存在,并通过评估动脉粥样硬化的标志物和血液生长分化因子(GDF-15)水平来评估HP对动脉粥样硬化的影响。为了评估动脉粥样硬化,通过超声波测量了CIMT。血清 GDF-15 水平采用 ELISA 方法测定。对所有患者的动脉粥样硬化标志物进行了记录。计算动脉粥样硬化指数,包括卡斯泰利风险指数 I 和 II(分别为 TG/HDL-c 和 LDL-c/HDL-c)、血浆动脉粥样硬化指数(PAI;对数 TG/HDL-c)、非 HDL-c(TH-HDL-c)和动脉粥样硬化系数(AC;非 HDL-HDL-c)。血清 GDF-15 水平与 CIMT 之间存在明显相关性(r = 0.445;p ≤ 0.001)。其他动脉粥样硬化指标与血清 GDF-15 水平或 CIMT 之间没有相关性。内镜标本上的细菌强度仅与 CIMT 相关(p < 0.001)。该研究表明,GDF-15 水平与 HP 患者亚临床动脉粥样硬化的发展存在相关性。然而,在致动脉粥样硬化指数正常的情况下,GDF-15水平却升高,这可能是亚临床动脉粥样硬化的早期标志物。
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