METHODS: This prospective case-control study was performed on patients with HP infection whom referred to 7 medical centers in 3 countries (Iran, Egypt, and Vietnam) in 2020-2021. The metabolic profile of all of the participants evaluated before starting of treatment for HP eradication and 3 months after the treatment. Then changes of metabolic profile compared between those with successful HP eradication (group A) and subjects who failed to eradicate (group B).
RESULTS: Overall, 199 patients, including 93 male (46.7%) with the mean age of 44.5 years (18-93 years) included. Based on response to treatment, the participants allocate into group A (those who respond to HP eradication): 164 cases (82.42%); or group B as those who failed to achieve eradication (35 cases, 17.58%). Racially 86.9% of participants were Caucasian and 89% diagnosed as non-ulcer dyspepsia (NUD). The most prevalent comorbidity include hypertension (11.5%) and hyperlipidemia (10%) which were more prevalent in group B (P = 0.002). Three months after therapy, average weight of participants among those who achieved eradication (group A) decreased from 73.1 to 71.4 kg (P = 0.01), but in comparison with group B, was non-significant (P = 0.171). The BMI of patients before and after treatment did not show any significant differences. The biochemical parameters of patients before and after treatment were not significantly different regardless of treatment success (P > 0.05). The levels of total cholesterol and VLDL cholesterol after treatment were not significantly different from baseline values in two groups. HDL and LDL cholesterol levels before and after treatment in the resistant group were significantly higher than the responding group. Average serum TG level decreased significantly after treatment in the group A (P < 0.0001), in contrast to the resistant group (P = 0.356). The liver transaminases (AST and ALT) before and after treatment were not significantly different between the two groups (P > 0.05). The results of logistic regression showed that the eradication of infection has no significant affect any of the metabolic profile parameters.
CONCLUSIONS: HP infection treatment in individuals without significant metabolic disorders does not affect metabolic parameters up to 3 months after eradication. HP eradication among subjects with several comorbidities mandates eradication protocol intensification to avoid treatment failure.
方法:这项前瞻性病例对照研究是针对HP感染患者进行的,这些患者转诊到3个国家的7个医疗中心(伊朗,埃及,和越南)在2020-2021年。在HP根除治疗开始前和治疗后3个月评估所有参与者的代谢概况。然后比较HP根除成功的受试者(A组)和未根除的受试者(B组)之间的代谢谱变化。
结果:总体而言,199名患者,包括93名男性(46.7%),平均年龄为44.5岁(18-93岁)。根据对治疗的反应,参与者分为A组(对HP根除有反应的人):164例(82.42%);或B组(35例,17.58%)。86.9%的参与者是白人,89%的参与者被诊断为非溃疡性消化不良(NUD)。最常见的合并症包括高血压(11.5%)和高脂血症(10%),在B组中更为普遍(P=0.002)。治疗三个月后,根除者(A组)的平均体重从73.1kg下降到71.4kg(P=0.01),但与B组相比,无显著性差异(P=0.171)。治疗前后患者的BMI无明显差异。无论治疗成功与否,患者治疗前后生化指标差异均无统计学意义(P>0.05)。两组治疗后总胆固醇和VLDL胆固醇水平与基线值无明显差异。耐药组治疗前后HDL和LDL胆固醇水平明显高于反应组。A组治疗后血清TG水平明显下降(P<0.0001),与耐药组相反(P=0.356)。两组治疗前后肝转氨酶(AST、ALT)比较差异无统计学意义(P>0.05)。Logistic回归结果表明,根除感染对任何代谢谱参数均无明显影响。
结论:在根除后3个月内,对无显著代谢紊乱的个体进行HP感染治疗不会影响代谢参数。在患有多种合并症的受试者中根除HP要求加强根除方案以避免治疗失败。