Hasan TUNCA, Tankut KOSEOGLU, Ersan OZASLAN, Engin SENNAROGLU, Narin NASIROGLU IMGA, Sibel UREYEN, Cumali EFE

Helicobacter Pylori CagA IgG Pozitif ve Negatif Hastalarda Serum Lipid Parametreleri Arasindaki İlişkinin Karşılaştırılması

Amaç: Helicobacter pylori (HP) kronik olarak insan midesini infekte eden bir bakteri olup gastrointestinal sistem dışında bazı hastalıklarla da ilişkili olabileceği yönünde birtakım düşünceler mevcuttur. Virülans belirteci olan CagA' nın, lipid profilini artmış inflamasyona bağlı olarak etkileyebileceği düşünülmekle beraber ateroskleroz patogenezinde ve lipidler üzerinde etkisi halen tartışmalıdır. Çalışmamızın amacı HP CagA IgG olan (pozitif) ve olmayan (negatif) olan hastalarda demografik veriler ve lipid düzeylerini karşılaştırmaktır.Materyal ve metod: Çeşitli dispeptik şikayetlerle polikliniğimize başvuran ve üre-nefes testi pozitif saptanıp üst gastrointestinal sistem endoskopisi yapılarak biyopsi bulgularında HP pozitif saptanan 74 hasta çalışmaya alındı. Hastaların serum örneklerinde CagA genine ait IgG antikorları ELISA yöntemi ile bakıldı. Hastalar iki gruba ayrıldı. HP CagA negatif (-) (grup 1) ve HP CagA IgG pozitif (+) (grup 2). Total kolesterol (TK), düşük yoğunluklu lipoprotein kolesterol (LDL-C), yüksek yoğunluklu lipoprotein kolesterol (HDL-C) ve trigliserid seviyeleri tüm hastalarda ölçüldü.Bulgular: Grup 1' de 36 hasta varken, grup 2' de 38 hasta vardı. Çalışma popülasyonunda HP CagA IgG (+) oranı %51 idi. Hastaların demografik verileri incelendiğinde yaş, cinsiyet, sigara ve alkol alışkanlığı, ekonomik durum ve öğrenim düzeyi arasında heriki grupta fark saptanmazken, mesleki olarak memurluk mesleğine sahip olanlarda her iki grup arasında anlamlı fark saptandı (p=0.013). Total kolesterol grup 1' de 168 mg/dl iken grup 2' de 188.5 mg/dl (p=0.162), LDL düzeyi grup 1' de 110.2 mg/dl iken grup 2' de 116.3 mg/dL (p =0.558), HDL düzeyi grup 1' de 45.2mg / dl iken grup 2' de 43.1 mg/dL (p =0.415), TG seviyesi grup 1' de 105.5 mg/dl iken grup 2' de 111.5 mg/dL (p=0.187) olarak saptandı. Her iki grupta lipid düzeyleri açısından anlamlı bir farklılık saptanmadı. Sonuç: Daha önce yapılan çalışmalarda HP CagA IgG pozitifliğinin atreoskleroz gelişimi ve lipid profili üzerine olumsuz etkisinin saptanmasına rağmen çalışmamızda HP CagA IgG negatif ve pozitif hastalarda HDL, LDL, TG ve TK düzeylerinde anlamlı bir değişiklik saptamadı. Bu sonuçların düşük inflamasyon veya hasta sayısının azlığından kaynaklandığı düşünülmektedir. Bu nedenle HP' nin aterosklerozla olan ilişkisinin belirlenmesinde daha ileri çalışmalara ihtiyaç duyulmaktadır.

The relationship between lipid parameters in Helicobacter pylori CagA IgG positive and negative patients

Aim: Helicobacter pylori (HP) is a bacterium that chronically infect the human stomach which is thought to be associated with certain diseases without the gastrointestinal tract. The virulence marker of HP cytotoxin-associated gene (CagA), may effect the lipid profile due to the increased inflammation, however the role in the pathogenesis of atherosclerosis and lipid profile still is controversial. We aimed to compare the demographic data and the lipid levels of HP infected patients with CagA IgG (positive) and without (negative). Materials and Methods: The 74 patients with various dyspeptic complaints and whose urea breath tests were detected as positive also biopsy of the upper gastrointestinal system endoscopy revealed HP positive were included to the study. The IgG antibody of CagA gene was measured by ELISA method in serum samples. Patients were divided into two groups. H. pylori CagA IgG negative (-) (group 1) and H. pylori CagA IgG positive (+) (group 2). Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride levels were measured in all patients.Results: In group 1, while the 36 patients in group 2, had 38 patients. Totally, 36 patients were detected in 1, while group 2 had 38 patients. The HP CagA IgG (+) rate was found 51% in study population. The demographic data of the patients revealed that age, gender, smoking, alcohol consumption, economic status and education status were not different between the groups, but patients who had the profession of civil servant, a significant difference was found between the groups (p=0.013). Total cholesterol was found 168 mg/dL in group 1, while in group 2 it was 188.5 mg/dL (p=0.162), LDL level of group 1 was found 110.2 mg/dL, while in group 2 it was found 116.3 mg/dL (p=0.558), HDL level was detected 45.2 mg/dL in group 1, while in group 2 it was found 43.1 mg/dL (p=0.415), TG level of group 1 was 105.5 mg/dL, while in group 2 it was found 111.5 mg/dL (p=0.187), respectively. No significant difference was found in terms of lipid levels in both groups.Conclusion: Previous studies suggest that HP CagA IgG positivity may have an adverse role in lipid profile and development of atherosclerosis, in spite of this theory in our study, we did not detect any significant changes between HDL, LDL, TG and TC levels in HP CagA IgG positive and negative patients. We consider these results are due to the small number of patients or low-grade inflammation. Therefore, further studies are needed to determine the relationship of H. pylori CagA and atherosclerosis.

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