| Background and purpose:Diabetes mellitus is a chronic disease characterized by elevated blood sugar content,which is widespread and increasing worldwide.Type 2 diabetes is dominant,its risk factors include socio-demographic factors and lifestyle,such as obesity,reduced exercise,poor diet and smoking.However,these factors can not fully explain the occurrence of the disease.Helicobacter pylori is one of the most common bacterial pathogens in humans.Its infection is related to chronic gastritis,peptic ulcer,gastric cancer and mucosa-associated lymphoid tissue lymphoma and many other gastric diseases.At present,some new data show that there is a strong relationship between Helicobacter pylori infection and the incidence of type 2 diabetes,but the mechanism is still unclear.Ghrelin and Leptin are produced in mammals’ stomach.Evidence suggests that Helicobacter pylori is involved in the regulation of these two hormones,thus affecting blood sugar control in diabetic patients.The purpose of this study is to study the relationship between type 2 diabetes mellitus and Helicobacter pylori infection,analyze the changes of glycosylated hemoglobin before and after the eradication of Helicobacter pylori,and further explore the possible role of related hormones Ghrelin and Leptin in this process,so as to guide the control of blood sugar and provide new ideas for clinical diagnosis and treatment.Method:A total of 60 patients with type 2 diabetes who met the diagnostic criteria of the American Diabetes Association in 1999 were enrolled in this study from January 2018 to February 2019 in the Department of Endocrinology,Taian Central Hospital.Firstly,13C-urea breath test was performed in all participants with type 2 diabetes mellitus,and13C-DOB value≥4 was used as the criterion for determining Hp positive.Type 2 diabetes mellitus patients were divided into Hp positive group(n=32)and Hp negative group(n=28)according to their Hp infection.After fasting for 12 hours,fasting blood samples were taken in the morning of the next day.FPG and Hb A1 c were measured by automatic biochemical analyzer in our hospital.Ghrelin and Leptin were detected by ELISA.The differences were compared.The positive components of Hp were divided into two subgroups: treatment group A(n=22)and untreated group B(n=10).Patients in group A were treated with anti-Hp quadruple therapy on the basis of giving hypoglycemic drugs and controlling diet for 14 days.The regimens were pantoprazole 40 mg bid,clarithromycin 500 mg bid,amoxicillin 1 g bid(penicillin allergic patients were treated with furazolidone 100 mg bid),colloidal bismuth pectin 200 mg bid,while patients in group B were only treated with current hypoglycemic drugs and diet control therapy.After3 months,13C-urea breath test was reexamined.Fasting blood was taken again with the same standard.The changes of FPG,Hb A1 c,Ghrelin and Leptin between the two subgroups were evaluated,so as to explore the effects of eradicating Hp on Hb A1 c and related hormones in type 2 diabetic patients.Result:1.In 60 cases of type 2 diabetes mellitus,according to 13C-DOB value(>4)as the positive judgment standard of Hp detection,32 cases of Hp positive were detected,the infection rate was 53%.2.There was no significant difference in age and sex between Hp positive group and negative group in type 2 diabetes mellitus(P>0.05).3.In type 2 diabetes mellitus,glycosylated hemoglobin was negatively correlated with Ghrelin and positively correlated with Leptin(P<0.05),while fasting blood glucose was not significantly correlated with Ghrelin and Leptin(P>0.05).4.The fasting blood glucose and glycosylated hemoglobin of type 2 diabetes patients with positive Hp were higher than those of type 2 diabetes patients with negative Hp(P<0.05).5.The fasting blood sugar and glycosylated hemoglobin in Hp-positive treatment group(group A)and non-treatment group(group B)decreased after 3 months compared with before 3 months,but the degree of reduction in group A was more obvious than that in group B,with statistical significance(P<0.05).6.The Ghrelin of patients with positive Hp was lower than that of patients with negative Hp,while Leptin was higher than that of patients with negative Hp,the difference was significant(P<0.05).7.Ghrelin and Leptin in patients with positive H.pylori also changed significantly before and after treatment.Ghrelin in patients with positive Hp was significantly higher than that before treatment(P<0.05),while Leptin was significantly lower than that before treatment(P>0.05).There was no significant change in the results of reexamination after 3months in the untreated group.Conclusion:There is a certain relationship between type 2 diabetes mellitus and Hp infection.FPG and Hb A1 c in Hp positive patients are higher than those in Hp negative patients.Fasting blood glucose and glycosylated hemoglobin decrease after eradication of Hp infection.Ghrelin and Leptin were correlated with glycosylated hemoglobin.It was also found that Ghrelin and Leptin had significant changes before and after eradication,suggesting that Hp might exert its influence on blood sugar by regulating Ghrelin and Leptin hormones. |
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