Association between Helicobacter pylori and mortality in the NHANES III study.

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

Gut

journal_title

Gut

authors

Chen Y,Segers S,Blaser MJ

doi

10.1136/gutjnl-2012-303018

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

1262-9

issue

9

eissn

0017-5749

issn

1468-3288

pii

gutjnl-2012-303018

journal_volume

62

pub_type

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