Relationship between Helicobacter pylori virulence genotypes and early renal damage in patients with peptic ulcer

doi:10.3969/j.issn.1673-8640.2022.01.003

Abstract

Abstract:

Objective To investigate the relationship between Helicobacter pylori（Hp） virulence genotypes and early renal damage in patients with peptic ulcers. Methods A total of 504 patients with peptic ulcer were enrolled and classified into Hp（-） group and Hp（+） group according to the presence or absence of Hp infection,and 100 healthy subjects were enrolled as healthy control group. The changes of renal function indicators in different groups were analyzed. The relationship between Hp virulence genes,inflammatory factors and immune response factors and early renal damage was evaluated. Logistic regression analysis was used to evaluate the influence factors for early renal damage in patients with peptic ulcers. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency of these indicators for the diagnosis of early renal damage in patients with peptic ulcers. Results Retinol binding protein（RBP）,urinary beta₂-microglobulin（β₂-MG）,urinary alpha₁-microglobulin（α₁-MG）,urinary transferrin（TF）,cystatin C（Cys C）,high-sensitivity C-reactive protein（hs-CRP）,immunoglobulin（Ig） A1 and vicia vilosa lectin（VVL）-IgA1 binding capacity in Hp（+） group had statistical significance compared with Hp（-） group and healthy control group（P<0.05）. The determination rate of cagA+vacA in patients with early renal damage in Hp（+） group was higher than that without early renal damage（P<0.05）. Logistic regression analysis showed that the course of disease,α₁-MG,RBP,Cys C,hs-CRP,IgA1,VVL-IgA1 binding capacity and the positive expression of cagA+vacA were influence factors for early renal damage in patients with peptic ulcer infected with Hp. The areas under curves of IgA1 and VVL-IgA1 binding capacity in the diagnosis of Hp-positive peptic ulcer with early renal damage were 0.792 and 0.773,respectively. The α₁-MG,RBP,Cys C,hs-CRP and VVL-IgA1 binding capacity in cagA+vacA group with Hp infection and early renal damage had statistical significance compared to that in non-cagA+vacA group（P<0.05）. Conclusions There is a certain proportion of early renal damage in patients with Hp infection and peptic ulcer,while the early renal damage is obvious in patients with cagA+vacA co-expression,which may be caused by inflammation and immune response.

Key words: Helicobacter pylori, Peptic ulcer, Early renal damage, Urinary albumin, Immunoglobulin A1

CLC Number:

R378.99

YAN Xisheng, LEI Lei, WANG Jian. Relationship between Helicobacter pylori virulence genotypes and early renal damage in patients with peptic ulcer[J]. Laboratory Medicine, 2022, 37(1): 16-22.

Figures/Tables 8

References 14

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基因名称	引物序列（5'~3'）	产物长度/bp
cagA	R：CTGAGCATTAACTAGCCCTTACGGTC	349
	F：GTCGTTTGCGTCACGTGGCAATGCTG
vacA	R：TGCGTCCGCATAACCGTGTAGTGCGG	678
	F：GCTTGAGTCCCGTTGCAATGCTATCA
ureA	R：CTGACGTGTATTAGTTTGATACGT	411
	F： GCTGGACGTTGTGGCGTAGTACG

基因名称	引物序列（5'~3'）	产物长度/bp
cagA	R：CTGAGCATTAACTAGCCCTTACGGTC	349
	F：GTCGTTTGCGTCACGTGGCAATGCTG
vacA	R：TGCGTCCGCATAACCGTGTAGTGCGG	678
	F：GCTTGAGTCCCGTTGCAATGCTATCA
ureA	R：CTGACGTGTATTAGTTTGATACGT	411
	F： GCTGGACGTTGTGGCGTAGTACG

组别	例数	年龄/岁	性别		病程/月	吸烟史/例	酗酒史/例	BMI/（kg/m²）
组别	例数	年龄/岁	男性/例	女性/例	病程/月	吸烟史/例	酗酒史/例	BMI/（kg/m²）
Hp（+）组	315	41.97±8.69	201	114	9.23±5.88	204	189	21.19±1.85
Hp（-）组	189	42.18±9.05	114	75	9.18±5.72	114	99	21.87±1.96
健康对照组	100	41.26±8.92	61	39		56	52	22.78±2.13
统计值		0.886	0.639		0.277	2.771	3.684	1.043
P值		0.501	0.707		0.821	0.250	0.159	0.474
组别	Urea/ （mmol/L）		UACR/ （mg/g）		GFR/ [mL/（min·1.73m²）]	RBP/（mg/L）	α₁-MG/ （mg/L）	β₂-MG/ （mg/L）
Hp（+）组	4.49±0.94		12.08±3.96		103.25±6.04	79.69±13.58^**##	14.09±5.94^**##	3.11±0.80^*#
Hp（-）组	3.87±0.76		11.29±3.92		108.94±6.92	59.36±10.26^*	10.46±2.82^*	2.26±0.49^*
健康对照组	3.74±0.71		9.23±1.61		112.34±7.66	49.58±9.28	7.31±2.79	1.89±0.52
统计值	3.362		2.965		2.447	8.662	9.032	7.741
P值	0.097		0.102		0.132	0.012	0.008	0.018
组别		TF/（mg/L）		Cys C/（mg/L）		hs-CRP/（mg/L）	IgA1/（g/L）	VVL-IgA1结合力/（AU/mg）
Hp（+）组		3.02±0.78^*#		1.84±0.29^**##		12.26±3.65^**##	2.39±0.99^**##	4.36±1.22^**##
Hp（-）组		1.18±0.37		1.12±0.21^*		8.67±1.93^**	1.82±0.81^*	2.73±0.94^*
健康对照组		1.21±0.26		0.65±0.22		4.77±1.34	1.29±0.64	1.44±0.58
统计值		8.437		9.325		8.271	11.092	19.094
P值		0.012		0.003		0.009	0.000	0.000

组别	例数	年龄/岁	性别		病程/月	吸烟史/例	酗酒史/例	BMI/（kg/m²）
组别	例数	年龄/岁	男性/例	女性/例	病程/月	吸烟史/例	酗酒史/例	BMI/（kg/m²）
Hp（+）组	315	41.97±8.69	201	114	9.23±5.88	204	189	21.19±1.85
Hp（-）组	189	42.18±9.05	114	75	9.18±5.72	114	99	21.87±1.96
健康对照组	100	41.26±8.92	61	39		56	52	22.78±2.13
统计值		0.886	0.639		0.277	2.771	3.684	1.043
P值		0.501	0.707		0.821	0.250	0.159	0.474
组别	Urea/ （mmol/L）		UACR/ （mg/g）		GFR/ [mL/（min·1.73m²）]	RBP/（mg/L）	α₁-MG/ （mg/L）	β₂-MG/ （mg/L）
Hp（+）组	4.49±0.94		12.08±3.96		103.25±6.04	79.69±13.58^**##	14.09±5.94^**##	3.11±0.80^*#
Hp（-）组	3.87±0.76		11.29±3.92		108.94±6.92	59.36±10.26^*	10.46±2.82^*	2.26±0.49^*
健康对照组	3.74±0.71		9.23±1.61		112.34±7.66	49.58±9.28	7.31±2.79	1.89±0.52
统计值	3.362		2.965		2.447	8.662	9.032	7.741
P值	0.097		0.102		0.132	0.012	0.008	0.018
组别		TF/（mg/L）		Cys C/（mg/L）		hs-CRP/（mg/L）	IgA1/（g/L）	VVL-IgA1结合力/（AU/mg）
Hp（+）组		3.02±0.78^*#		1.84±0.29^**##		12.26±3.65^**##	2.39±0.99^**##	4.36±1.22^**##
Hp（-）组		1.18±0.37		1.12±0.21^*		8.67±1.93^**	1.82±0.81^*	2.73±0.94^*
健康对照组		1.21±0.26		0.65±0.22		4.77±1.34	1.29±0.64	1.44±0.58
统计值		8.437		9.325		8.271	11.092	19.094
P值		0.012		0.003		0.009	0.000	0.000

组别	例数	cagA+vacA/[例（%）]	cagA/[例（%）]	vacA/[例（%）]	ureA/[例（%）]
无肾损伤组	256	91（30.95）	27（10.85）	68（26.56）	70（33.67）
早期肾损伤组	59	30（57.14）	5（8.47）	15（25.42）	9（19.04）
χ²值		5.945	0.226	0.032	3.196
P值		0.015	0.653	0.858	0.074