The Correlation Between Helicobacter Pylori And Colorectal Adenomas Was Investigated Based On The Propensity Score Matching Method

Objective:This study aims to investigate the correlation between Helicobacter pylori(Hp)and adenomatosis of colon and rectum(ACR),and to provide a new prevention direction for preventing the occurrence and development of ACR.Methods:This study retrospectively analyzed patients who underwent colonoscopy(including pathology)and Hp detection from the Department of Gastroenterology,Nanchang First Hospital from July 2017 to July 2022.The first step is to collect the basic demographic information and relevant biochemical indicators of the patients,and establish the final research subjects according to the inclusion exclusion criteria;In the second step,according to the results of colonoscopy and pathology,the research subjects were divided into ACR group and non-ACR group,and the variables related to ACR were screened out by univariate analysis,and the variables screened out were used as covariates in this study except for the research variables.In the third step,the Hp test results are used as group variables,and whether the distribution of each covariate in the Hp positive group and the Hp negative group is balanced,if more than2 covariates are unevenly distributed between the two groups,the propensity score matching(PSM)method is used to match,and the data that are not successfully matched are eliminated,so that the covariate distribution between the two groups after matching is balanced;In the fourth step,conditional logistic regression was performed on the matched data to analyze whether the incidence of ACR in the Hp positive and Hp-negative groups was statistically significant,and whether there was a correlation between Hp infection and the occurrence of ACR.Results:A total of 1471 patients were enrolled as study subjects,and univariate analysis showed that odds ratio(OR)= 1.961 P <0.05),age(rs=0.281 P<0.05),BMI(rs=0.139P<0.05),hyperlipidemia(OR=1.587 P<0.05),diabetes mellitus(OR=2.252 P<0.05),hypertension(OR=2.407 P<0.05),smoking history(OR=2.185 P<0.05),and drinking history(OR=1.881 P).<0.05)and Hp infection(OR=1.578 P<0.05)were associated with the occurrence of ACR,while fatty liver,appendectomy history,and cholecystectomy history were not significantly different in the ACR group and non-ACR group(P>0.05),so sex,age,BMI,hyperlipidemia,diabetes,hypertension,smoking history,and alcohol consumption history were used as covariates in this study.The distribution of sex,age,hyperlipidemia,BMI,smoking history and drinking history before matching was uneven between the Hp positive group and the Hp negative group(P<0.05),and a total of 641 pairs were matched after the propensity score was matched,and the above covariates were evenly distributed between the two groups after matching,and the difference was not statistically significant(P>).0.05),conditional logistic regression was performed on the matched data,and it was concluded that the incidence of ACR was statistically significant between the Hp-positive group and the Hp-negative group,and there was a weak correlation between Hp infection and the occurrence of ACR OR=1.367 95%confidence interval[(95% confidence interval,95% Cl): 1.164-1.606 P=0.000 <0.05].Conclusion:There is a positive correlation between Hp and the occurrence of ACR,the incidence of Hp-positive ACR is 1.367 times that of Hp-negative patients,and it is recommended to improve colonoscopy in Hp-positive patients,but a larger and more standardized prospective cohort study is still needed in the future to further demonstrate the correlation and pathogenic mechanism between Hp and ACR.