Research Article: Association of TyG and TyG/HDL with Helicobacter pylori infection status and urea breath test load: a cross-sectional study
Abstract:
To evaluate the associations of the triglyceride–glucose index (TyG) and the TyG/high-density lipoprotein cholesterol ratio (TyG/HDL-C) with Helicobacter pylori infection status and the corresponding dose–response pattern, and to explore whether bacterial activity–related load, as reflected by delta over baseline (DOB) is associated with TyG and TyG/HDL-C among H. pylori –positive individuals.
We retrospectively screened 705 hospitalized patients at our center. H. pylori positivity was defined as a delta over baseline (DOB) ? 4‰ on the 13 C-urea breath test ( 13 C-UBT). Logistic regression was used to estimate odds ratios (ORs) for H. pylori positivity in relation to TyG and TyG/HDL-C, and restricted cubic splines (RCS) were applied to assess potential nonlinearity. Among H. pylori –positive participants, DOB was used as a proxy for bacterial activity–related load. We examined associations of ln(DOB) with TyG and TyG/HDL-C using linear regression, conducted sensitivity analyses, and performed additional subgroup and interaction analyses stratified by age and BMI.
Of 705 participants, 238 were H. pylori –positive (33.8%). TyG was independently associated with H. pylori positivity (OR 1.472, 95% CI 1.096–1.978; P = 0.010), and RCS suggested a nonlinear association (P for nonlinearity = 0.005). TyG/HDL-C was associated with H. pylori positivity in unadjusted and partially adjusted models (OR 1.239; P = 0.011) but was not significant after full adjustment (OR 1.158; P = 0.102). Additional subgroup analyses showed that the association between TyG and H. pylori positivity was stronger among participants with BMI ? 24 kg/m 2 (P for interaction = 0.009), whereas the association between TyG/HDL-C and H. pylori positivity varied by age (P for interaction = 0.025). Among H. pylori –positive participants, ln(DOB) was not significantly associated with TyG or TyG/HDL-C, and results were unchanged after excluding extreme DOB values. The association between TyG and H. pylori positivity remained robust after excluding participants with diabetes and those with extreme triglyceride values.
TyG is independently associated with H. pylori infection status with a nonlinear dose–response pattern. The association between TyG/HDL-C and H. pylori positivity was not significant after full adjustment. No clear association is observed between DOB and TyG or TyG/HDL-C among H. pylori –positive individuals.
Introduction:
Helicobacter pylori is a Gram-negative bacterium that primarily colonizes the stomach, infecting approximately half of the global population ( 1 ). H. pylori infection can trigger gastric mucosal inflammation and is closely associated with the development and progression of gastritis, peptic ulcer disease, and gastric cancer ( 2 ). The triglyceride–glucose (TyG) index, calculated from fasting triglycerides and glucose, is a simple surrogate marker of insulin resistance ( 3 ), and the TyG/HDL-C ratio may provide…
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