Helicobacter pylori and hepatitis A virus infections and the cardiovascular risk profile in patients with diabetes mellitus: results of a population-based study.

Objective: The objective of this study was to investigate the associations of sero-positivity for Helicobacter pylori (HP) and hepatitis A virus infection (HAV) with prevalence of cardiovascular diseases (CVD) and CVD-risk markers in a large population-based sample of patients with diabetes mellitus (DM), who are at high risk of developing CVD.

Background: Several studies have suggested that chronic infections are associated with the development of atherosclerosis and coronary heart diseases (CHD).

Methods: This analysis is based on the German National Health Interview and Examination Survey which was conducted in 1998. We identified all subjects with prevalent DM aged 40-79 years. Helicobacter pylori and HAV status were measured by serum immunoglobulin G antibodies. Prevalence of several CVD events (myocardial infarction, stroke and CHD) was recorded. In addition, serum levels of total triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and lipoprotein (a) were measured.

Results: Among the 4285 participants of the German Health Survey aged 40-79 years, we identified 365 patients with DM. Of these, 32.1% had at least one CVD and there was a clear increase of CVD with age. Sero-prevalence of HP or HAV and their combination was not associated with the prevalence of CVD nor with mean levels of blood lipids after multivariate adjustment for covariates.

Conclusion: In this large group of 365 patients with diabetes mellitus no association of HP and HAV sero-prevalence with presence of CVDs or the level of serum lipids was established. Therefore it seems unlikely that HP and HAV sero-prevalence strongly influence CVD progression in patients with diabetes.