Keywords
Atherosclerosis
Amazon
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Abstract
Objective: To investigate the association between Helicobacter pylori virulence genotypic profiles and atherosclerosis, emphasizing the role of the metabolic-nutritional axis in adults from Xingu, Pará. Methods: Cross-sectional study with 92 adults undergoing endoscopy, PCR for bacterial detection and genotyping (CagA and VacA), and vascular doppler to measure carotid intima-media thickness (CIMT). Plasma and cardiometabolic biomarkers were analyzed. Results: Infection prevalence was 43.5%. Infected individuals showed lower vitamin B12 levels (481.48 vs. 644.92 pg/mL; p=0.016). Virulent strains predominated (VacA s1 82.5%; CagA 55.0%), with the CagA⁺/VacA s1⁺ profile associated with greater CIMT severity (p=0.003). In multivariate analysis, the metabolic-nutritional axis emerged as the main independent risk predictor (OR=4.84; p=0.016), overcoming isolated infection. Conclusion: The use of PCR as a molecular gold standard strengthens the thesis that H. pylori indirectly modulates cardiovascular risk by depressing the metabolic-nutritional axis. The main limitation is the cross-sectional design of the study, which prevents establishing exact temporal causality. Key words: Helicobacter pylori, Atherosclerosis, Amazon.
References
ARAMOUNI S, et al. Helicobacter pylori and carotid intima-media thickness: a recent update and meta-analysis. Journal of Clinical Medicine, 2023; 12(4): 1540-1555.
ATRISCO MJ, et al. In Peripheral Blood Mononuclear Cells Helicobacter Pylori Induces the Secretion of Soluble and Exosomal Cytokines Related to Carcinogenesis. Int. J. Mol. Sci. 2022
BACKERT S, et al. Virulence mechanisms of Helicobacter pylori. Nature Reviews Microbiology, 2023; 21: 1-15.
BARRETO ML, et al. Social determinants of infectious diseases in Brazil. The Lancet Regional Health – Americas, 2022; 8: 100184.
CHEY WD, et al. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of Gastroenterology, 2024; 119(9): 1481-1502.
DENG L, et al. Association between Helicobacter pylori infection and metabolic syndrome: a meta-analysis of 40 studies. Frontiers in Endocrinology, 2023; 14: 1154–1168.
EUROPEAN SOCIETY OF CARDIOLOGY. Guidelines for the Management of Acute Coronary Syndromes. European Heart Journal, 2023; 44(38): 3720-3826.
FARIAS PM, et al. Cardiometabolic risk in Amazonian populations. Cadernos de Saúde Pública, 2023.
FERNANDES R, et al. Inflammatory markers and endothelial dysfunction in Helicobacter pylori-positive patients. Clinical Microbiology and Infection, 2023; 29(4): 600–609.
FERREIRA CR, et al. Helicobacter pylori and systemic diseases: pathophysiological bridges beyond the stomach. Revista da Sociedade Brasileira de Medicina Tropical, 2024; 57(6): 211–227.
HATAKEYAMA M. Helicobacter pylori CagA and disease mechanisms. Nature Reviews Gastroenterology & Hepatology, 2022; 19: 67-68.
HOFFMAN RM, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology, 2023; 165(4): 950–960.
LI J, et al. Helicobacter pylori and vitamin B12 metabolism. Frontiers in Nutrition, 2021; 8: 738001.
LIBBY P, et al. Atherosclerosis: the next decade. Nature Reviews Drug Discovery, 2023; 22(9): 690–712.
MALFERTHEINER P, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut, 2022; 71(9): 1724-1762.
MALIK R, et al. Helicobacter pylori infection and systemic biomarkers: insights into cardiovascular risk. Journal of Clinical Lipidology, 2024; 18(2): 410–422.
OLAS B. Homocysteine and cardiovascular risk. International Journal of Molecular Sciences, 2022; 23(15): 8332.
POLYZOS SA, et al. Helicobacter pylori and cardiovascular risk. European Journal of Internal Medicine, 2022; 100: 17-25.
RIDKER PM. Inflammation in atherosclerosis and cardiovascular disease. New England Journal of Medicine, 2022; 386(20): 1871-1882.
ROTHMAN KJ, et al. Modern epidemiology. 4. ed. Philadelphia: Wolters Kluwer, 2021.
SANTOS-GALLEGO CG, et al. H. pylori and coronary artery disease: the inflammatory link. Journal of the American College of Cardiology, 2022; 79(10): 963-965.
SILVA SB, et al. Prevalence and risk factors for Helicobacter pylori infection in the Brazilian Amazon. Revista da Sociedade Brasileira de Medicina Tropical, 2022; 55(6): 211–227.
TANG B, et al. Emerging therapies for Helicobacter pylori eradication: personalized and adjunctive strategies. Gastroenterology Report, 2023; 11(2): 87–98.
TSAO, CW, et al. Heart disease and stroke statistics-update: a report from the American Heart Association. Circulation, 2022; 145(8): e153–e639.
TUFANO A, et al. Helicobacter pylori and cardiovascular risk: an old player or a new challenge? Internal and Emergency Medicine, 2021; 16(5): 1125–1135.
WANG X, et al. Association between helicobacter pylori infection and subclinical atherosclerosis. Medicine, 2021; 100(46): e27840.