Abstract:
OBJECTIVE:Persistent colonisation by Helicobacter pylori, and especially by cagA-positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality. DESIGN:We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of H pylori status with all-cause and cause-specific mortality. Analyses for the association of H pylori cagA positivity with mortality were conducted in 7384 subjects with data on H pylori cagA status. RESULTS:In older people (> 40.1 years), H pylori was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of H pylori status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for H pylori cagA positivity, with the HR of 0.45 (95% CI 0.27 to 0.76). H pylori was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini-Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and H pylori status was not related to other outcomes. CONCLUSIONS:Our findings suggest that H pylori has a mixed role in human health, but is not a major risk factor for all-cause mortality.
journal_name
Gutjournal_title
Gutauthors
Chen Y,Segers S,Blaser MJdoi
10.1136/gutjnl-2012-303018subject
Has Abstractpub_date
2013-09-01 00:00:00pages
1262-9issue
9eissn
0017-5749issn
1468-3288pii
gutjnl-2012-303018journal_volume
62pub_type
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