Gender-associated differences in urea breath test for Helicobacter pylori infection referrals and results among dyspeptic patients.

Aim: To verify whether there is a gender difference in the (13)C-urea breath test results in a large cohort.

Methods: The test results of dyspeptic patients referred for (13)C-urea breath testing between January and December, 2007 were evaluated. Testing was carried out at the health insurance organization branches and evaluated at a central laboratory in Israel.

Results: Of a total of 28 746 test results, 18 122 (63.04%) were from females and 10 624 (36.95%) from males. Overall, 10 188 (35.4%) results [expressed as delta over baseline (DOB)] were positive (DOB (13)C > 5), 18,326 (63.7%) were negative (DOB (13)C < 3.5) and 232 (0.8%) were borderline (DOB (13)C 3.5-5). There was a significant difference between the total positive rate among females and males (34.8% vs 37.2%, respectively, P = 0.0003). The mean test value was increased by approximately 10 units for females compared to males (P < 0.01) and this difference was consistent for all age groups (i.e., between 10-80 years of age, P < 0.01).

Conclusion: More females were referred to (13)C-urea breath testing. More males had positive results. The mean test values were significantly higher among females of all age groups, possibly representing an increased bacterial load among females and suggesting gender-associated differences in Helicobacter pylori host interactions.