H. Pylori is Related to Osteoporosis but Only in Premenopausal Female: a Cross-sectional Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2020 Aug 20

PMID 32811503

Citations 1

Authors

Jing-Wei Wang

Feng-Xiao Dong

Hui Su

Licun Zhu

Sujun Shao

Hong Liu

Affiliations

Soon will be listed here.

Abstract

Background: Recently, an increasing number of studies have focused on the extra-gastrointestinal effects of Helicobacter pylori (H. pylori), including metabolic syndrome, fatty liver, and rheumatic and skin diseases. Osteoporosis is an asymptomatic disease that can eventually lead to fractures and has a significant impact on the quality of life of elderly individuals. Sex is an influential factor that plays a crucial role in the development of osteoporosis. The aim of this study was to investigate the relationship between H. pylori infection and osteoporosis and to identify potential influencing factors.

Methods: We conducted a cross-sectional study of individuals older than 50 years old, who had undergone regular physical examinations at the Beijing Shijitan Hospital Health Examination Center from July to October 2018. We evaluated the associations of osteopenia and osteoporosis with H. pylori infection and related serum markers by using multiple linear regression and logistic regression. Then, we analysed the correlation between sex and potential serum biomarkers.

Results: There were significant relationships between H. pylori infection status and bone density in premenopausal females but not in males (P = 0.381) according to Fisher's exact test. In females, H. pylori positivity (OR = 0.132, P = 0.023), Body Mass Index (BMI) (OR = 28.163, P = 0.021), and homocysteine (HCY) (OR = 17.218, P = 0.045) were associated with osteoporosis. Calcium had a trend but no statistically significant (OR = 0.060, P = 0.076) relationship with osteoporosis. Furthermore, the waist-to-hip ratio (OR = 5.783, P = 0.029), BMI (OR = 0.152, P = 0.014) and triglyceride levels (OR = 0.201, P = 0.036) were significantly different by sex, after adjusting for age as a confounder.

Conclusion: H. pylori positivity, BMI and HCY are associated with osteoporosis in premenopausal females. Chronic inflammation may be involved in the relationship between H. pylori and osteoporosis.

Citing Articles

Safety Evaluation of Natural Drugs in Chronic Skeletal Disorders: A Literature Review of Clinical Trials in the Past 20 years.

Zhou D, Zhang H, Xue X, Tao Y, Wang S, Ren X Front Pharmacol. 2022; 12:801287.

PMID: 35095508 PMC: 8793129. DOI: 10.3389/fphar.2021.801287.

References

Avcu N, Avcu F, Beyan C, Ural A, Kaptan K, Ozyurt M . The relationship between gastric-oral Helicobacter pylori and oral hygiene in patients with vitamin B12-deficiency anemia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92(2):166-9. DOI: 10.1067/moe.2001.113589. View

Asaoka D, Nagahara A, Shimada Y, Matsumoto K, Ueyama H, Matsumoto K . Risk factors for osteoporosis in Japan: is it associated with Helicobacter pylori?. Ther Clin Risk Manag. 2015; 11:381-91. PMC: 4358368. DOI: 10.2147/TCRM.S80647. View

Shih H, Hsu T, Chen C, Lin C, Kao C, Chen C . Analysis of Patients with Helicobacter pylori Infection and the Subsequent Risk of Developing Osteoporosis after Eradication Therapy: A Nationwide Population-Based Cohort Study. PLoS One. 2016; 11(9):e0162645. PMC: 5023099. DOI: 10.1371/journal.pone.0162645. View

McMillan J, Fatehi-Sedeh S, Sylvia V, Bingham V, Zhong M, Boyan B . Sex-specific regulation of growth plate chondrocytes by estrogen is via multiple MAP kinase signaling pathways. Biochim Biophys Acta. 2006; 1763(4):381-92. DOI: 10.1016/j.bbamcr.2006.02.010. View

Tyagi N, Dhesy-Thind S . Clinical practice guidelines in breast cancer. Curr Oncol. 2018; 25(Suppl 1):S151-S160. PMC: 6001762. DOI: 10.3747/co.25.3729. View

Malfertheiner P, Megraud F, OMorain C, Atherton J, Axon A, Bazzoli F . Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut. 2012; 61(5):646-64. DOI: 10.1136/gutjnl-2012-302084. View

Tucker K, Hannan M, Qiao N, Jacques P, Selhub J, Cupples L . Low plasma vitamin B12 is associated with lower BMD: the Framingham Osteoporosis Study. J Bone Miner Res. 2004; 20(1):152-8. DOI: 10.1359/JBMR.041018. View

Serin E, Gumurdulu Y, Ozer B, kayaselCuk F, Yilmaz U, Kocak R . Impact of Helicobacter pylori on the development of vitamin B12 deficiency in the absence of gastric atrophy. Helicobacter. 2002; 7(6):337-41. DOI: 10.1046/j.1523-5378.2002.00106.x. View

Clarke B, Khosla S . Physiology of bone loss. Radiol Clin North Am. 2010; 48(3):483-95. PMC: 2901252. DOI: 10.1016/j.rcl.2010.02.014. View

10.

Lin S, Koo M, Tsai K . Association between Helicobacter pylori Infection and Risk of Osteoporosis in Elderly Taiwanese Women with Upper Gastrointestinal Diseases: A Retrospective Patient Record Review. Gastroenterol Res Pract. 2014; 2014:814756. PMC: 4053086. DOI: 10.1155/2014/814756. View

11.

Asaoka D, Nagahara A, Hojo M, Sasaki H, Shimada Y, Yoshizawa T . The Relationship between H. pylori Infection and Osteoporosis in Japan. Gastroenterol Res Pract. 2014; 2014:340765. PMC: 4082917. DOI: 10.1155/2014/340765. View

12.

Dontas I, Yiannakopoulos C . Risk factors and prevention of osteoporosis-related fractures. J Musculoskelet Neuronal Interact. 2007; 7(3):268-72. View

13.

Chinda D, Shimoyama T, Iino C, Matsuzaka M, Nakaji S, Fukuda S . Decrease of Estradiol and Several Lifestyle Factors, but Not Helicobacter pylori Infection, Are Significant Risks for Osteopenia in Japanese Females. Digestion. 2017; 96(2):103-109. DOI: 10.1159/000479317. View

14.

Nguyen N, Ahlborg H, Center J, Eisman J, Nguyen T . Residual lifetime risk of fractures in women and men. J Bone Miner Res. 2007; 22(6):781-8. DOI: 10.1359/jbmr.070315. View

15.

Tang D, Kumar S . The Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease. Curr Gastroenterol Rep. 2017; 19(2):5. DOI: 10.1007/s11894-017-0545-1. View

16.

Gennari L, Bilezikian J . New and developing pharmacotherapy for osteoporosis in men. Expert Opin Pharmacother. 2018; 19(3):253-264. DOI: 10.1080/14656566.2018.1428559. View

17.

Glaser D, Kaplan F . Osteoporosis. Definition and clinical presentation. Spine (Phila Pa 1976). 1998; 22(24 Suppl):12S-16S. DOI: 10.1097/00007632-199712151-00003. View

18.

Matsuhisa T, Aftab H . Observation of gastric mucosa in Bangladesh, the country with the lowest incidence of gastric cancer, and Japan, the country with the highest incidence. Helicobacter. 2012; 17(5):396-401. PMC: 3469740. DOI: 10.1111/j.1523-5378.2012.00967.x. View

19.

Pan B, Huang C, Chuah S, Chiang J, Loke S . Relationship between Helicobacter pylori infection and bone mineral density: a retrospective cross-sectional study. BMC Gastroenterol. 2018; 18(1):54. PMC: 5921984. DOI: 10.1186/s12876-018-0780-4. View

20.

Upala S, Jaruvongvanich V, Riangwiwat T, Jaruvongvanich S, Sanguankeo A . Association between Helicobacter pylori infection and metabolic syndrome: a systematic review and meta-analysis. J Dig Dis. 2016; 17(7):433-40. DOI: 10.1111/1751-2980.12367. View