Helicobacter pylori infection is not associated with diabetes mellitus, nor with upper gastrointestinal symptoms in diabetes mellitus

OBJECTIVE: The association between Helicobacter pylori (H. pylori) infectio n and diabetes mellitus is controversial. We aimed to determine the prevale nce of H. pylori infection in patients with diabetes and nondiabetic contro ls, and assess whether H. pylori infection was associated with upper gastro intestinal (GI) symptoms in diabetes mellitus. METHODS: A total of 429 patients with type 1 (n = 49) or type 2 (n = 380) d iabetes mellitus (48.6% women, mean age 60.7 yr) and 170 nondiabetic contro ls (34.7% women, mean age 60.4 yr) were evaluated. All subjects completed a validated questionnaire (the Diabetes Bowel Symptom Questionnaire) to dete rmine upper GI symptoms, and a blood sample was tested for H. pylori infect ion using a validated ELISA kit (sensitivity 96%, specificity 93%). RESULTS: Seroprevalence of H. pylori was 33% and 32%, respectively, in pati ents with diabetes and controls (NS). In both groups, the seroprevalence wa s significantly higher in men than in women; 39% vs 25% (p = 0.002) in diab etic patients, and 40% vs 20% (p = 0.01) in controls. Patients with diabete s had a significantly higher prevalence of early satiety (OR = 2.30), fulln ess (OR = 3.15), and bloating (OR = 1.50) compared with controls. Upper GI symptoms were present in 49% of H. pylori-positive and 53% of H. pylori-neg ative patients with diabetes (OR = 0.87, 95% CI 0.58-1.31, p = 0.56). H. py lori infection was also not associated with any of the individual upper GI symptoms before or after adjustment for potential confounding factors. Howe ver, patient age and female gender were identified as independent risk fact ors for upper GI symptoms. Smoking was a risk factor for bloating and early satiety. CONCLUSIONS: H. pylori infection appears not to be associated with diabetes mellitus or upper GI symptoms in diabetes mellitus. (Am J Gastroenterol 20 01;96:1039-1046. (C) 2001 by Am. Coll. of Gastroenterology).