幽門桿菌感染與代謝症候群及代謝相關脂肪肝病、肝纖維化風險研究

Abstract

幽門螺旋桿菌感染已知是消化性潰瘍、非賁門胃癌和胃黏膜相關淋巴淋巴瘤的危險因子，其也與一些胃外表現的風險增加有關，例如心血管、神經、血液和代謝疾病。本研究旨在瞭解瞭解研究對象的人口學變項以及幽門螺旋桿菌感染之現況。探討社會人口學與幽門螺旋桿菌、代謝症候群、代謝功能障礙相關脂肪性肝病及肝纖維化之差異及相關性。本研究為觀察性橫斷面研究，蒐集台灣北部某區域教學醫院健康檢查中心資料，自2021年9月至2024年8月為期三年的時間，共有2343位接受自費健康檢查的民眾。並以獨立樣本t 檢定、卡方檢定、羅吉斯回歸和線性迴歸進行統計分析。本研究發現，在幽門螺旋桿菌感染者中，50-59 歲年齡層比例最高。共病分析顯示，幽門螺旋桿菌感染與代謝症候群及糖尿病呈顯著正相關。特別是幽門螺旋桿菌感染與代謝症候群之間的關聯性更為顯著（勝算比 [Odds Ratio] = 1.810，95% 信賴區間 [CI]: 1.229–2.665，p = 0.003）。然而，幽門螺旋桿菌感染與其他代謝相關疾病（如肥胖、脂肪肝、MASLD 及肝纖維化）的關聯性未達統計顯著性。研究結果指出，幽門螺旋桿菌感染可能是代謝症候群的一項重要風險因子。另一方面，脂肪肝與男性、ALT 指數及胰島素阻抗呈較高相關性，而肝纖維化則與年齡及 B 型肝炎較為相關。基於上述結果，建議未來應針對 50-59 歲高風險族群進行篩查與早期介入，並評估其代謝症候群風險，以便及早進行干預。此外，建議增加代謝症候群及糖尿病患者的胃鏡檢查篩檢率。同時，未來研究可進一步比較同一批幽門螺旋桿菌感染者在接受根除治療之後的差異，並分析根除治療的時間點（較早或較晚除菌）對代謝相關疾病的影響，為制定精準干預策略提供更多依據。Helicobacter pylori infection is known to be a risk factor for peptic ulcer, non-cardia gastric cancer, and mucosa-associated lymphoid tissue lymphoma. It is also associated with an increased risk of various extragastric manifestations, including cardiovascular, neurological, hematological, and metabolic diseases. This study aims to investigate the demographic characteristics of the study population and the prevalence of H. pylori infection. It further explores the differences and correlations between socio-demographic factors, H. pylori infection, metabolic syndrome (MetS), metabolic-associated fatty liver disease (MASLD), and liver fibrosis.This cross-sectional study analyzed data from 2,343 individuals who underwent voluntary health checkups at a teaching hospital in northern Taiwan from September 2021 to August 2024. Independent sample t-test, chi-square test, logistic regression, and linear regression were used for statistical analysis.The results showed that the prevalence of H. pylori infection was highest among individuals aged 50-59 years. H. pylori infection was positively associated with metabolic syndrome and diabetes. More importantly, H. pylori infection was significantly associated with metabolic syndrome (Odds Ratio = 1.810, 95% CI: 1.229-2.665, p = 0.003). However, no significant association was found with other metabolic diseases such as obesity and metabolic-associated fatty liver disease (MASLD), and liver fibrosis. The study results indicate that Helicobacter pylori infection may be an important risk factor for metabolic syndrome. On the other hand, fatty liver is more strongly associated with male gender, ALT levels, and insulin resistance, while liver fibrosis is more significantly related to age and hepatitis B.Future studies should focus on screening and interventions for high-risk populations, particularly those aged 50-59 years, and assess their risk for metabolic syndrome. Additionally, increasing endoscopy screening rates for individuals with metabolic syndrome and diabetes is recommended. Further studies comparing individuals with and without H. pylori infection, as well as those who underwent early or late eradication therapy, could provide more insights into the long-term effects of H. pylori infection and inform public health strategies.