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KMID : 0384320150360050227
Korean Journal of Family Medicine
2015 Volume.36 No. 5 p.227 ~ p.232
Association between Helicobacter pylori Infection and Cerebral Small Vessel Disease
Jang Soo-Hyun

Lee Hye-Jin
Kim Jun-Suk
Park Hyun-Jung
Jeong Seung-Yong
Lee Sang-Hyun
Kim Hyun-Ho
Park Jin-Ho
Shin Dong-Wook
Yun Jae-Moon
Cho Be-Long
Kwon Hyung-Min
Abstract
Background: Small vessel disease is an important cause of cerebrovascular diseases and cognitive impairment in the elderly. There have been conflicting results regarding the relationship between Helicobacter pylori infection and ischemic stroke. This study aimed to examine the association between H. pylori infection and cerebral small vessel disease.

Methods: The study included 1,117 patients who underwent brain magnetic resonance imaging and H. pylori identification between 2005 and 2013 at Health Promotion Center, Seoul National University Hospital. Multivariable logistic regression analysis was used to assess the association between H. pylori infection and small vessel disease with adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, smoking status, problem drinking, and antiplatelet use.

Results: The adjusted odds ratios (aORs) for the association between H. pylori infection and silent brain infarction and cerebral microbleeds were 1.03 (95% confidence interval [CI], 0.66-1.61) and 0.70 (95% CI, 0.38-1.28), respectively. The aORs for silent brain infarction and cerebral microbleeds were 0.81 (95% CI, 0.44-1.44) and 0.59 (95% CI, 0.30-1.18) in patients aged <65 years and 1.59 (95% CI, 0.78-3.22) and 1.89 (95% CI, 0.38-9.33) in those aged >65 years, respectively. Moreover, the aORs for silent brain infarction and cerebral microbleeds were 0.96 (95% CI, 0.54-1.71) and 0.74 (95% CI, 0.33-1.69) in H. pylori-infected patients without atrophic gastritis and 0.89 (95% CI, 0.48-1.62) and 0.99 (95% CI, 0.43-2.27) in those with atrophic gastritis, respectively.

Conclusion: No association between H. pylori infection and small vessel disease was observed. H. pylori-induced inflammation may not be a risk factor for microcirculatory damage in the brain.
KEYWORD
Helicobacter pylori, Small Vessel Disease, Silent Brain Infarction, Cerebral Microbleeds
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