Helicobacter pylori infection selectively increases the risk for carotid atherosclerosis in young males

Abstract Background and aims Atherosclerosis is an important contributing factor to cardiovascular mortality. The role of Helicobacter pylori (H. pylori) infection in atherosclerosis is inconsistent and sometimes controversial. The present study aimed to determine if H. pylori infection was associated with carotid atherosclerosis. Methods 17,613 males and females with both carotid ultrasonic examination and 13C-urea breath test for H. pylori infection were screened by a major Chinese university hospital from March 2012–March 2017 for the study. Baseline demographics, cardiac risk factors, and laboratory studies were obtained. After exclusion for pre-specified conditions, 12,836 individuals were included in the analysis, including 8,157 men (63.5%) and 4,679 women (36.5%). Analysis was also made from 5-year follow-up data for 1,216 subjects (869 males and 347 females) with and without H. pylori infection for development and progression of carotid atherosclerosis. Results After adjusting for age, sex, body mass index, lipid profile, hypertension, renal function, diabetes mellitus, and smoking, H. pylori infection was found as an independent risk factor for carotid atherosclerosis in males under 50 years old, but not in older males or females (odds ratio 1.229, 95% CI 1.054–1.434, p = 0.009). Follow-up data analysis showed that the incidence of carotid atherosclerosis from no atherosclerosis to detectable lesions was significantly higher in young males with persistent H. pylori infection than those without H. pylori infection (p = 0.028) after 3 years. Conclusions These data suggest that H. pylori infection might be an important risk factor for carotid atherosclerosis in young Chinese males under 50.