Review
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World J Gastroenterol. Apr 28, 2014; 20(16): 4607-4617
Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4607
Helicobacter pylori infection and diabetes: Is it a myth or fact?
Cong He, Zhen Yang, Nong-Hua Lu
Cong He, Zhen Yang, Nong-Hua Lu, Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: He C, Yang Z and Lu NH contributed equally to the review and writing of this paper.
Supported by The National Natural Science Foundation of China, No. 81060038 and No. 81270479, and grants from Jiangxi Province Talent 555 Project, and the National Science and Technology Major Projects for “Major New Drugs Innovation and Development” of China, No. 2011ZX09302-007-03
Correspondence to: Nong-Hua Lu, MD, Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, 17 Yong Waizheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. lunonghua@ncu.edu.cn
Telephone: +86-791-88692705 Fax: +86-791-88623153
Received: November 27, 2013
Revised: February 10, 2014
Accepted: March 6, 2014
Published online: April 28, 2014
Abstract

Helicobacter pylori (H. pylori) is one of the most common human bacterial pathogens, and infection causes a wide array of gastric disorders, including simple gastritis, peptic ulcers and gastric malignancies. Gastrointestinal inflammation caused by H. pylori can influence the absorption of glucose and lipids, which are also abnormal in diabetes mellitus. Type 2 diabetes mellitus (T2DM), formerly known as non-insulin-dependent diabetes mellitus or adult-onset diabetes, is a metabolic disorder that is characterized by high levels of blood glucose resulting from insulin resistance and relative insulin deficiency. It is an emerging pandemic and is rapidly becoming a serious threat to public health. Emerging data now indicate a strong relationship between H. pylori infection and the incidence of T2DM. The mechanisms underlying the pathogenesis of diabetes are complex, involving insulin resistance, chronic inflammation, insulin secretion deficiency as a result of pancreas β-cell dysfunction, glucotoxicity, and lipotoxicity. H. pylori infection is known to be involved in the pathogenesis of insulin resistance, and the growing awareness of its role in diabetes is important for the early detection of glucose dysregulation and prevention of T2DM in high-risk communities. This review probes the possible relationship between H. pylori and diabetes according to epidemiological surveys and discusses putative mechanisms underlying this correlation.

Keywords: Helicobacter pylori, Type 2 diabetes, Insulin resistance, Inflammation, Cytokines

Core tip: A growing body of evidence suggests that Helicobacter pylori (H. pylori) infection is associated with diabetes, and may cause insulin resistance and chronic inflammation that contribute to the disease. H. pylori-induced gastritis can also potentially affect the secretion of gastric-related hormones and inflammatory cytokines. However, the relationship between H. pylori infection and diabetes is still under debate and further studies are warranted to define their association in more detail, and to characterize the corresponding mechanisms and mediators.