期刊
GUT
卷 62, 期 9, 页码 1262-1269出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/gutjnl-2012-303018
关键词
Helicobacter Pylori; Epidemiology; Gastric Cancer; Cardiovascular Disease; Pancreatic Cancer
资金
- National Institutes of Health [R01DK090989, R01GM63270, ES000260, P30CA16087]
- Diane Belfer Program for Human Microbial Ecology
Objective Persistent colonisation by Helicobacter pylori, and especially by cagA-positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality. Design We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of H pylori status with all-cause and cause-specific mortality. Analyses for the association of H pylori cagA positivity with mortality were conducted in 7384 subjects with data on H pylori cagA status. Results In older people (>40.1years), H pylori was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of H pylori status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for H pylori cagA positivity, with the HR of 0.45 (95% CI 0.27 to 0.76). H pylori was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini-Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and H pylori status was not related to other outcomes. Conclusions Our findings suggest that H pylori has a mixed role in human health, but is not a major risk factor for all-cause mortality.
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