Influence of Helicobacter pylori Infection on Atherosclerosis Risk Factors in Older People

  • Zean Zefenkey Department of Medical Laboratory Science, College of Science, Knowledge University, Erbil 44001, Iraq
Keywords: Helicobacter pylori, atherosclerosis, older people, cardiovascular diseases, faecal H. pylori antigen test


Atherosclerosis is a significant cause of mortality from cardiovascular disease. The role of Helicobacter pylori (H. pylori) infection in atherogenesis is debatable. The current study aimed to assess the association between H. pylori infection and some risk factors of atherosclerosis in older people. 180 males and females, apparently healthy, over 60 years old, were examined by Fecal Helicobacter Pylori-Antigen ELISA test for H. pylori infection. Blood pressure, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), triglyceride (TG), fasting blood glucose, and body mass index (BMI) were measured for all participants.

The faecal H. pylori antigen-positive group had a lower HDL-cholesterol level and higher levels of LDL-cholesterol, triglyceride, fasting blood glucose, and BMI than the faecal H. pylori antigen-negative group with a statistical difference (P < 0.05). The faecal H. pylori antigen-positive group had 2.4, 2.2, 2.6, 2.5 fold more likely to have increasing in the LDL-cholesterol, triglyceride, BMI, and decreasing in HDL-cholesterol, respectively. This risk became more considerable after adjustment for gender, age, blood pressure, and fasting blood glucose (adjusted odds ratio (AOR)= 3.1, 3.0, 3.3, 3.3), respectively.

The infection by H. pylori in older adults is an independent factor for increasing lipid profile and BMI, which are the key modifying factors for the progress of atherosclerosis.

Author Biography

Zean Zefenkey, Department of Medical Laboratory Science, College of Science, Knowledge University, Erbil 44001, Iraq

Department of Medical Laboratory Science, College of Science, Knowledge University, Erbil 44001, Iraq – (


Ahima, R. S., & Flier, J. S. (2000). Leptin. Annual review of physiology, 62, 413–437.
Akbas, H. S., Basyigit, S., Suleymanlar, I., Kemaloglu, D., Koc, S., Davran, F., Demir, I., & Suleymanlar, G. (2010). The assessment of carotid intima media thickness and serum paraoxonase-1 activity in Helicobacter pylori positive subjects. Lipids in health and disease, 9, 92.
Aronow W.S., Frishman W.H. (2001) Risk Factors for Atherosclerosis in the Elderly. In: Rosenthal R.A., Zenilman M.E., Katlic M.R. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. doi: 10.1007/978-1-4757-3432-4_31
Atkinson, N. S., & Braden, B. (2016). Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy. Digestive diseases and sciences, 61(1), 19–24.
Bado, A., Levasseur, S., Attoub, S., Kermorgant, S., Laigneau, J. P., Bortoluzzi, M. N., Moizo, L., Lehy, T., Guerre-Millo, M., Le Marchand-Brustel, Y., & Lewin, M. J. (1998). The stomach is a source of leptin. Nature, 394(6695), 790–793.
Bener, A., Ağan, A. F., Al-Hamaq, A., Barisik, C. C., Öztürk, M., & Ömer, A. (2020). Prevalence of Helicobacter pylori Infection among Type 2 Diabetes Mellitus. Advanced biomedical research, 9, 27.
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., Delling, F. N., Djousse, L., Elkind, M., Ferguson, J. F., Fornage, M., Jordan, L. C., Khan, S. S., Kissela, B. M., Knutson, K. L., Kwan, T. W., … American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee (2019). Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation, 139(10), e56–e528.
Bhatt, D. L., Steg, P. G., Ohman, E. M., Hirsch, A. T., Ikeda, Y., Mas, J. L., Goto, S., Liau, C. S., Richard, A. J., Röther, J., Wilson, P. W., & REACH Registry Investigators (2006). International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA, 295(2), 180–189.
Buzás G. M. (2014). Metabolic consequences of Helicobacter pylori infection and eradication. World journal of gastroenterology, 20(18), 5226–5234.
Chen, L. W., Chien, C. Y., Hsieh, C. W., Chang, L. C., Huang, M. H., Huang, W. Y., Kuo, S. F., Chien, C. H., Lin, C. L., & Chien, R. N. (2016). The Associations Between Helicobacter pylori Infection, Serum Vitamin D, and Metabolic Syndrome: A Community-Based Study. Medicine, 95(18), e3616.
Chmiela, M., Gajewski, A., & Rudnicka, K. (2015). Helicobacter pylori vs coronary heart disease - searching for connections. World journal of cardiology, 7(4), 187–203.
Fisher, L., Fisher, A., & Smith, P. N. (2020). Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review). Journal of clinical medicine, 9(10), 3253.
Francois, F., Roper, J., Joseph, N., Pei, Z., Chhada, A., Shak, J. R., de Perez, A. Z., Perez-Perez, G. I., & Blaser, M. J. (2011). The effect of H. pylori eradication on meal-associated changes in plasma ghrelin and leptin. BMC gastroenterology, 11, 37.
Haider, A. W., Wilson, P. W., Larson, M. G., Evans, J. C., Michelson, E. L., Wolf, P. A., O'Donnell, C. J., & Levy, D. (2002). The association of seropositivity to Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus with risk of cardiovascular disease: a prospective study. Journal of the American College of Cardiology, 40(8), 1408–1413.
Hemmat, N., Ebadi, A., Badalzadeh, R., Memar, M. Y., & Baghi, H. B. (2018). Viral infection and atherosclerosis. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 37(12), 2225–2233.
Hooi, J., Lai, W. Y., Ng, W. K., Suen, M., Underwood, F. E., Tanyingoh, D., Malfertheiner, P., Graham, D. Y., Wong, V., Wu, J., Chan, F., Sung, J., Kaplan, G. G., & Ng, S. C. (2017). Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology, 153(2), 420–429.
Ikeda, A., Iso, H., Sasazuki, S., Inoue, M., Tsugane, S., & JPHC Study Group (2013). The combination of Helicobacter pylori- and cytotoxin-associated gene-A seropositivity in relation to the risk of myocardial infarction in middle-aged Japanese: The Japan Public Health Center-based study. Atherosclerosis, 230(1), 67–72.
Kasai, C., Sugimoto, K., Moritani, I., Tanaka, J., Oya, Y., Inoue, H., Tameda, M., Shiraki, K., Ito, M., Takei, Y., & Takase, K. (2016). Changes in plasma ghrelin and leptin levels in patients with peptic ulcer and gastritis following eradication of Helicobacter pylori infection. BMC gastroenterology, 16(1), 119.
Khoshbayan, A., Taheri, F., Moghadam, M. T., Chegini, Z., & Shariati, A. (2021). The association of Chlamydia pneumoniae infection with atherosclerosis: Review and update of in vitro and animal studies. Microbial pathogenesis, 154, 104803.
Kountouras, J., Papaefthymiou, A., Gavalas, E., Polyzos, S. A., Boziki, M., Kyriakou, P., Katsinelos, P., Zavos, C., Liatsos, C., Tzivras, D., Tzitiridou-Chatzopoulou, M., Dardiotis, E., Deretzi, G., Vardaka, E., & Doulberis, M. (2020). Helicobacter pylori infection as a potential risk factor for multiple sclerosis. Medical hypotheses, 143, 110135.
Kountouras, J., Polyzos, S. A., Katsinelos, P., Zeglinas, C., Artemaki, F., Tzivras, D., Vardaka, E., Gavalas, E., Romiopoulos, I., Simeonidou, C., Grigoriadis, N., Kountouras, C., Dardiotis, E., & Deretzi, G. (2017). Cardio-cerebrovascular disease and Helicobacter pylori-related metabolic syndrome: We consider eradication therapy as a potential cardio-cerebrovascular prevention strategy. International journal of cardiology, 229, 17–18.
Lee, M., Baek, H., Park, J. S., Kim, S., Kyung, C., Baik, S. J., Lee, B. K., Kim, J. H., Ahn, C. W., Kim, K. R., & Kang, S. (2018). Current Helicobacter pylori infection is significantly associated with subclinical coronary atherosclerosis in healthy subjects: A cross-sectional study. PloS one, 13(3), e0193646.
Lujan-Vega, C., Keel, M. K., Barker, C. M., & Hawkins, M. G. (2021). Evaluation of Atherosclerotic Lesions and Risk Factors of Atherosclerosis in Raptors in Northern California. Journal of avian medicine and surgery, 35(3), 295–304.
Makoveichuk, E., Vorrsjö, E., Olivecrona, T., & Olivecrona, G. (2017). TNF-α decreases lipoprotein lipase activity in 3T3-L1 adipocytes by up-regulation of angiopoietin-like protein 4. Biochimica et biophysica acta. Molecular and cell biology of lipids, 1862(5), 533–540.
Markus, H. S., & Mendall, M. A. (1998). Helicobacter pylori infection: a risk factor for ischaemic cerebrovascular disease and carotid atheroma. Journal of neurology, neurosurgery, and psychiatry, 64(1), 104–107.
Park, M. J., Choi, S. H., Kim, D., Kang, S. J., Chung, S. J., Choi, S. Y., Yoon, D. H., Lim, S. H., Kim, Y. S., Yim, J. Y., Kim, J. S., & Jung, H. C. (2011). Association between Helicobacter pylori Seropositivity and the Coronary Artery Calcium Score in a Screening Population. Gut and liver, 5(3), 321–327.
Pearson-Stuttard, J., Guzman-Castillo, M., Penalvo, J. L., Rehm, C. D., Afshin, A., Danaei, G., Kypridemos, C., Gaziano, T., Mozaffarian, D., Capewell, S., & O'Flaherty, M. (2016). Modeling Future Cardiovascular Disease Mortality in the United States: National Trends and Racial and Ethnic Disparities. Circulation, 133(10), 967–978.
Pohjanen, V. M., Koivurova, O. P., Niemelä, S. E., Karttunen, R. A., & Karttunen, T. J. (2016). Role of Helicobacter pylori and interleukin 6 -174 gene polymorphism in dyslipidemia: a case-control study. BMJ open, 6(1), e009987.
Rahman, L. Q., Rahman, A. Q., Bakir, A. A., Muhamadamin, R. A., & Khudhur, P. K. (2020). DNA detection of Helicobacter pylori in saliva of patients with low salivary pH. Zanco Journal of Medical Sciences (Zanco J Med Sci), 24(2), 283-290.
Robinson, K., & Atherton, J. C. (2021). The Spectrum of Helicobacter-Mediated Diseases. Annual review of pathology, 16, 123–144.
Rogha, M., Nikvarz, M., Pourmoghaddas, Z., Shirneshan, K., Dadkhah, D., & Pourmoghaddas, M. (2012). Is helicobacter pylori infection a risk factor for coronary heart disease?. ARYA atherosclerosis, 8(1), 5–8.
Ross R. (1993). The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature, 362(6423), 801–809.
Shimamoto, T., Yamamichi, N., Gondo, K., Takahashi, Y., Takeuchi, C., Wada, R., Mitsushima, T., & Koike, K. (2020). The association of Helicobacter pylori infection with serum lipid profiles: An evaluation based on a combination of meta-analysis and a propensity score-based observational approach. PloS one, 15(6), e0234433.
Sturlaugsdottir, R., Aspelund, T., Bjornsdottir, G., Sigurdsson, S., Thorsson, B., Eiriksdottir, G., & Gudnason, V. (2016). Prevalence and determinants of carotid plaque in the cross-sectional REFINE-Reykjavik study. BMJ open, 6(11), e012457.
Sun, Y., Fu, D., Wang, Y. K., Liu, M., & Liu, X. D. (2016). Prevalence of Helicobacter pylori infection and its association with lipid profiles. Bratislavske lekarske listy, 117(9), 521–524.
Tabata, N., Sueta, D., Akasaka, T., Arima, Y., Sakamoto, K., Yamamoto, E., Izumiya, Y., Yamamuro, M., Tsujita, K., Kojima, S., Kaikita, K., Morita, K., Oniki, K., Saruwatari, J., Nakagawa, K., & Hokimoto, S. (2016). Helicobacter pylori Seropositivity in Patients with Interleukin-1 Polymorphisms Is Significantly Associated with ST-Segment Elevation Myocardial Infarction. PloS one, 11(11), e0166240.
Upala, S., Sanguankeo, A., Saleem, S. A., & Jaruvongvanich, V. (2017). Effects of Helicobacter pylori eradication on insulin resistance and metabolic parameters: a systematic review and meta-analysis. European journal of gastroenterology & hepatology, 29(2), 153–159.
Wan, Z., Hu, L., Hu, M., Lei, X., Huang, Y., & Lv, Y. (2018). Helicobacter pylori infection and prevalence of high blood pressure among Chinese adults. Journal of human hypertension, 32(2), 158–164.
Wan, Z., Song, L., Hu, L., Hu, M., Lei, X., Huang, Y., & Lv, Y. (2020). Helicobacter pylori infection is associated with diabetes among Chinese adults. Journal of diabetes investigation, 11(1), 199–205.
Wang, J. W., Tseng, K. L., Hsu, C. N., Liang, C. M., Tai, W. C., Ku, M. K., Hung, T. H., Yuan, L. T., Nguang, S. H., Yang, S. C., Wu, C. K., Chiu, C. H., Tsai, K. L., Chang, M. W., Huang, C. F., Hsu, P. I., Wu, D. C., & Chuah, S. K. (2018). Association between Helicobacter pylori eradication and the risk of coronary heart diseases. PloS one, 13(1), e0190219.
Warren, J. R., & Marshall, B. (1983). Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet (London, England), 1(8336), 1273–1275.
Xu, X., Li, W., Qin, L., Yang, W., Yu, G., & Wei, Q. (2019). Relationship between Helicobacter pylori infection and obesity in Chinese adults: A systematic review with meta-analysis. PloS one, 14(9), e0221076.
Zhang, L., Chen, Z., Xia, X., Chi, J., Li, H., Liu, X., Li, R., Li, Y., Liu, D., Tian, D., Wang, H., Petroski, G. F., Flaker, G. C., Hao, H., Liu, Z., & Xu, C. (2019). Helicobacter pylori infection selectively increases the risk for carotid atherosclerosis in young males. Atherosclerosis, 291, 71–77.
How to Cite
Zefenkey, Z. (2022). Influence of Helicobacter pylori Infection on Atherosclerosis Risk Factors in Older People. Science Journal of University of Zakho, 10(1), 24-28.
Science Journal of University of Zakho