Association Between Helicobacter Pylori Infection and Metabolic and Biochemical Biomarkers in Adults: A Cross-Sectional Analysis of NHANES Data

Abstract

Background: Helicobacter pylori infection has been associated with metabolic abnormalities, including impaired glucose regulation, dyslipidemia, and systemic inflammation. However, the extent to which these associations occur across multiple metabolic and biochemical domains in a nationally representative U.S. population remains incompletely characterized. This study examined the relationship between H. pylori seropositivity and metabolic and biochemical biomarkers among U.S. adults using NHANES 1999–2000 data.
Methods: A cross-sectional analytical framework was developed for adults aged ≥20 years with interpretable H. pylori IgG serology. Prespecified outcomes included glycemic, lipid and adiposity, inflammatory, hepatic, and routine biochemical biomarkers. NHANES complex survey design variables and outcome-appropriate examination or fasting subsample weights were incorporated into the planned analyses. Multivariable models were designed to adjust sequentially for demographic, socioeconomic, and behavioral covariates, with false-discovery-rate control for multiple biomarker comparisons.
Results: Published NHANES 1999–2000 benchmark data showed that H. pylori-seropositive adults had higher glucose, triglycerides, C-reactive protein, AST, and GGT levels and lower serum iron than seronegative adults. The largest relative differences were observed for GGT, triglycerides, and glucose, whereas total cholesterol and creatinine showed little separation. Standardized comparisons similarly indicated that the overall magnitude of biomarker differences was generally modest and concentrated within selected metabolic-inflammatory pathways rather than being uniformly distributed across all biochemical measures.
Conclusion: H. pylori seropositivity appears to be associated with a selective metabolic-inflammatory profile characterized particularly by glycemic, triglyceride, and hepatic-enzyme differences. These findings should be interpreted as associations rather than causal effects. Independent survey-weighted analysis of the participant-level NHANES files is required before the reported estimates can be considered definitive.