Association between Helicobacter pylori and mortality in the NHANES III study

作者：Chen Yu^*; Segers Stephanie; Blaser Martin J

来源：Gut, 2013, 62(9): 1262-1269.

DOI：10.1136/gutjnl-2012-303018

• Helicobacter Pylori
• Epidemiology
• Gastric Cancer
• Cardiovascular Disease
• Pancreatic Cancer

Objective
Persistent colonisation by Helicobacter pylori, and especially by cagA-positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality.
Design
We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of H pylori status with all-cause and cause-specific mortality. Analyses for the association of H pylori cagA positivity with mortality were conducted in 7384 subjects with data on H pylori cagA status.
Results
In older people (>40.1years), H pylori was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of H pylori status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for H pylori cagA positivity, with the HR of 0.45 (95% CI 0.27 to 0.76). H pylori was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini-Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and H pylori status was not related to other outcomes.
Conclusions
Our findings suggest that H pylori has a mixed role in human health, but is not a major risk factor for all-cause mortality.

• 出版日期2013-9