Relationship Between Inflammatory Factors In Type 2 Diabetes And HP Infection

Objective: To explore the changes of inflammatory cytokines levels,activies of regulators,and insulin resistance index(IRI)of the type 2 diabets patients with Helicobater pylori infection so as to open up new ideas for further study of pathogenesis of H.pylori infection in the type 2 diabets patients.To investigate the prevalence of helicobacter pylori(HP)in type two diabetics,and the relations of infection with upper gastrointestinal tract symptoms and endoscopic feactures,observe efficacy of triple therapy.Methods: From March 2010 to Jun 2011,totally 260 patients who were hospitalized in the department of endocrinology and department of gastroenterology were enrolled in the study and divided into the non-diabetes chronic superficial gastritis H.pylori infection group,the type 2 diabtes without H.pylori infection group,and the type 2 diabetes complicated with H.pylori infection group according to the status of H.pylori inflection,with 65 case in each,meanwhile 65 patients without diabetes or stomach illness that matched with the 260 cases in age and gender were chosen as the control group,then the serum high sensitive C-reactive protein(h S-CRP)was tested by means of immunofluorescence assay,the levels of serum interleukin-6(IL-6),interleukin-1?(IL-1?),and turor necrosis factor-?(TNF-?)were determined with the use of ELISA method,the activity of the endogenous nuclear factor-?B(NF-?B)in peripheral blood was testd by means of immunohistichemistry method;the fasting plasma glucose level was tested by using the oxidase method;the fasting insulin leveal was tested with the use of radioimmunoassay,and the H.pylori was detected by means of 13 C breath test.A parallel-controlled study was conducted between 125 type 2 diabetics and 125 nondiabetics without gastric disease in digest clinic.All the patients had dyspeptic symptoms and gastroscopy,serum antibody?rapid urease test and 14C-UBT examination were performed to diagnose HP infection,upper gastrointestinal symptoms and diabetic duration were noted in detail,upper gastrointestinal tract perspective after barium strip by mouth was needed to diagnose gastroparesis in diabetics.All patients affected by HP received the same triple therapy for 1 week,4 weeks later after therapy,recheck 14C-UBT to investigate the eradication rates of HP.Results:(1)The levels of serum hs-CRP,IL-6,and TNF-?of the type 2 diabetes patients complicated with H.pylori inflection were respectively(12.25±2.37)mg/L,(22.39±3.50)ng/L,and(34.73±5.16)ng/L,significantly higher than those of other three groups,the differences were significant(P<0.05).The activity of NF-?B in the peripheral blood of the type 2 diabetes patients complicated with H.pylori inflection was(129.26±10.83)pg/m L,the IFI 14.75±4.14,significantly higher than those of other three groups(P<0.05).The IL-1? level was(10.52±2.87)ng/L in the type 2 diabets complicated with H.(9.39±1.14)ng/L in the type 2 diabetes without H.pylori inflection group,the different was not significant.(2)The difference of H.pylori prevalence between diabetics and controls was not significant(p>0.05),but the diabetics with gastroparesis had a higher incidence of HP than those without gastroparesis and controls,the difference was significant(p<0.05);The infection rate had an increased tendency with diabetic duration;The incidence of early satiety?nausea?distention?superior belly pain were higher in diabetics affected by HP than those were not affected(p<0.05);The incidence of early satiety and distention was higher in diabetics with gastroparesis and HP infection than other groups(p<0.01);The eradication rate of HP in diabetics was lower than in controls,there was a significant difference between the two groups(p<0.05).Conclusion:(1)The levels of the inflammatory cytokines are elevated under the joint action of hyperglycemia and H.pylori,which can activate the NF-?B,induce the insulin resistance,and lead to or accelerate the emergence and development of H.pylori inflection,consequently,the NF-?B can be used as a novel drug target for anti-inflammation therapy for patients with H.pylori inflection.(2)The infection of HP may be associated with gastroparesis in diabetics.The infection rate had an increased tendency with diabetic duration.Upper gastrointestinal tract symptoms in diabetics may be associated with HP infection,eradication of HP may be helpful to improve these symptoms,but the eradication rate of H.pylori is lower in diabetics than in nondiabetics.