Data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) were utilized for this study, with a final of 4370 participants included. Both univariable and multivariable-adjusted logistic regression analyses were employed to explore the relationship between H. pylori infection and pertinent covariates. Cox regression analysis, as well as restricted regression cubic spline analysis, were utilized to assess the association between DII and all-cause mortality among individuals with or without H. pylori infection.
The findings demonstrated a positive correlation between DII scores and H. pylori infection, even after adjusting for potential confounding factors. Moreover, higher DII scores were significantly associated with an elevated risk of mortality exclusively in individuals with H. pylori infection, while no such association was observed in the uninfected population. Additional analysis using restricted cubic spline modeling revealed a positive linear relationship between DII scores as a continuous variable and the adjusted risk of all-cause mortality specifically in H. pylori-infected patients.
The results of this study indicated that DII was positively correlated with an increased risk of H. pylori infection and was associated with a heightened risk of all-cause mortality solely in individuals with H. pylori infection. Consequently, DII might serve as a useful tool for risk stratification in the H. pylori-infected population among U.S. adults. Further research is warranted to elucidate the underlying mechanisms and potential clinical implications of these findings.
方法:本研究利用了1999-2018年国家健康和营养调查(NHANES)的数据,包括4370名参与者。采用单变量和多变量调整逻辑回归分析来探索幽门螺杆菌感染与相关协变量之间的关系。Cox回归分析,以及受限回归三次样条分析,用于评估有或没有幽门螺杆菌感染的个体中DII与全因死亡率之间的关联。
结果:研究结果表明DII评分与幽门螺杆菌感染呈正相关,即使在调整了潜在的混杂因素之后。此外,较高的DII评分与仅幽门螺杆菌感染个体的死亡风险升高显著相关,而在未感染人群中未观察到这种关联。使用限制性三次样条模型的其他分析显示,作为连续变量的DII评分与全因死亡率的调整风险之间存在正线性关系,特别是在幽门螺杆菌感染患者中。
结论:本研究结果表明,DII与幽门螺杆菌感染的风险增加呈正相关,并且仅与幽门螺杆菌感染个体的全因死亡风险增加相关。因此,DII可能是美国成年人中幽门螺杆菌感染人群风险分层的有用工具。需要进一步的研究来阐明这些发现的潜在机制和潜在的临床意义。