H. pylori infection, HbA1c levels increase colorectal adenoma risk
The combination of Helicobacter pylori infection and elevated haemoglobin A1c (HbA1c) levels is likely to increase the risk of colon adenoma, a recent study suggests.
Researchers conducted a cross-sectional, retrospective study at the MacKay Memorial Hospital in Taiwan to investigate the interaction between H. pylori and hyperglycaemia status on the risk of colon adenoma.
A total of 3,943 participants aged >40 years undergoing bidirectional gastrointestinal endoscopy on the same day between July 2006 and June 2015 were included. All patients had a gastric biopsy specimen tested for H. pylori. The main outcome was colon adenoma with and without H. pylori infection at different HbA1c levels.
The prevalence of colorectal adenomas was 37.3 percent in patients who were H. pylori‒positive and 27.29 percent in those who were H. pylori‒negative. Age, male sex, body mass index, H. pylori infection and HbA1c ≥6.5 percent were independent risk factors for adenoma based on multivariable logistic regression analysis. This risk was reduced with the use of hypoglycaemic agents.
HbA1c levels, regardless of H. pylori status, increased the prevalence of adenoma. For patients with H. pylori, the odds ratio (OR) for adenoma was 1.44 (95 percent CI, 1.20 to 1.73), whereas those without H. pylori but had HbA1c ≥7.0 percent had an OR of 1.68 (1.05 to 2.70). If both conditions were present, the OR was 4.79 (2.92 to 7.84).
A 1-percent increase in HbA1c correlated with an increased prevalence of adenoma by 42.4 percent in H. pylori‒positive patients.
“Both H. pylori and type 2 diabetes mellitus are possible risk factors for colon adenoma,” researchers said.