The inter-relationship between Helicobacter pylori infection, dementia and mortality in type 2 diabetes: The Fremantle Diabetes Study Phase I

J Diabetes Complications. 2024 Nov;38(11):108854. doi: 10.1016/j.jdiacomp.2024.108854. Epub 2024 Sep 5.

Abstract

Background: Given sparse relevant data, the aim of this study was to determine whether Helicobacter pylori infection, including cytotoxin-associated gene-A (CagA) producing strains, is associated with dementia in type 2 diabetes (T2DM).

Methods: Longitudinal data from 1115 participants in the community-based Fremantle Diabetes Study Phase I (mean age 64.0 years, 48.0 % males; 38.0 % H. pylori seronegative, 24.3 % H. pylori seropositive/CagA seronegative, and 37.7 % H. pylori/CagA seropositive at baseline) were analyzed.

Results: During up to 19 years of follow-up, 50.3 % and 83.5 % of participants without and with incident dementia, respectively, died. In Cox proportional hazards models, H. pylori/CagA seropositivity (hazard ratio (95 % CI) 1.68 (1.15, 2.46), P = 0.008), but not H. pylori seropositivity/CagA seronegativity (P = 0.541) was an independent predictor of incident dementia, but neither H. pylori seropositivity/CagA seronegativity nor H. pylori/CagA seropositivity were significant predictors in competing risks models (P ≥ 0.280).

Conclusions: Although CagA seropositivity in T2DM may have a contributory etiologic role in the risk of dementia, this may be through its association with reduced cardiovascular/all-cause mortality.

Keywords: Cytotoxin-associated gene-A; Dementia; Helicobacter pylori; Mortality; Type 2 diabetes.

MeSH terms

  • Aged
  • Antigens, Bacterial / blood
  • Antigens, Bacterial / immunology
  • Bacterial Proteins
  • Dementia* / epidemiology
  • Dementia* / microbiology
  • Dementia* / mortality
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / mortality
  • Female
  • Follow-Up Studies
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / epidemiology
  • Helicobacter Infections* / mortality
  • Helicobacter pylori* / isolation & purification
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models

Substances

  • cagA protein, Helicobacter pylori
  • Antigens, Bacterial
  • Bacterial Proteins