The Association Between Helicobacter Pylori Infection And Depressive Symptoms Among Adults

Aims:Depressive symptoms are a common,debilitating,and costly public health problem.Studies have shown that intestinal diseases are closely related to depressive symptoms.Helicobacter pylori（H.pylori）infection caused changes in the normal physiological state of the gastrointestinal flora,and was one of the most common pathogens of gastrointestinal diseases.The aim of this study was to investigate the association between H.pylori infection status and depressive symptoms in the general population of Tianjin by detecting H.pylori infection.Methods:A cross-sectional study was conducted on participants from Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study.It mainly includes people who participated in the cohort study from June 2013 to December 2016.During this period,the study population underwent physical examination and completed a detailed health factors questionnaire.All participants voluntarily participated in the study and signed the informed consent.A total of 5,558 subjects were selected after inclusion and exclusion criteria.Depressive symptoms were evaluated using a Chinese version of the Zung Self-Rating Depression Scale（SDS）with 20 items.The SDS score ranged from20 to 80 points.This study used SDS≥45 as the cutoff value to indicate whether the subject has depressive symptoms;H.pylori infection was diagnosed using carbon-13urea breath test(¹³C-UBT).This study used SAS software 9.3 for statistical analysis of all data.In this study,the association between inflammatory levels in vivo and H.pylori infection was compared by covariance analysis.Multivariate logistic regression analysis was used to analyze the association between H.pylori infection and depressive symptoms.Results:In the total population of the study,the prevalence rate of depressive symptoms was 12.7%for men and 17.4%for women,respectively,the detection rate of depressive symptoms in women is higher than in men.The leukocyte level,lymphocyte level and neutrophil level were higher in H.pylori infection group than in the non-infected group in the men population,and the association was statistically significant（P<0.0001）.The leukocyte level and neutrophil level in the H.pylori-infected group were higher than those in the non-infected group in women,and the association was statistically significant（P<0.0001）.There were no significant associations in both genders for neutrophil-to-lymphocyte ratio and H.pylori infection.In the multivariate Logistic regression analysis,the final results after adjusting for a variety of confounders showed that:H.pylori infection was only observed in the women population and was associated with a higher prevalence of depressive symptoms:in the multivariate adjustment model（model 4）,The odds ratios（OR）（95%confidence interval,95%CI）of having elevated depressive symptoms by H.pylori infection were 1.26（1.01-1.56）,1.43（1.09-1.88）and 1.47（1.05-2.06）at the SDS?45,SDS?48,and SDS?50 levels.However,no significant difference was found between H.pylori infection and depressive symptoms in men.Conclusions:This study found that H.pylori infection was associated with high prevalence of depressive symptoms in women,but no association was found in men.In future studies,more large sample population studies and random experimental studies are needed to determine the causal link between H.pylori infection and depressive symptoms,as well as to explore the mechanisms of etiology.