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Gut doi:10.1136/gutjnl-2012-303018
  • Helicobacter pylori
  • Original article

Association between Helicobacter pylori and mortality in the NHANES III study

  1. Martin J Blaser2
  1. 1Department of Population Health, New York University School of Medicine, New York, USA
  2. 2Department of Medicine, New York University School of Medicine, New York, USA
  1. Correspondence to Dr Yu Chen, Department of Population Health, New York University School of Medicine, 650 First Avenue, Room 510, New York, NY 10016, USA; yu.chen{at}nyumc.org
  • Received 1 June 2012
  • Revised 23 November 2012
  • Accepted 3 December 2012
  • Published Online First 8 January 2013

Abstract

Objective Persistent colonisation by Helicobacter pylori, and especially by cagA-positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality.

Design We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of H pylori status with all-cause and cause-specific mortality. Analyses for the association of H pylori cagA positivity with mortality were conducted in 7384 subjects with data on H pylori cagA status.

Results In older people (>40.1 years), H pylori was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of H pylori status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for H pylori cagA positivity, with the HR of 0.45 (95% CI 0.27 to 0.76). H pylori was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini–Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and H pylori status was not related to other outcomes.

Conclusions Our findings suggest that H pylori has a mixed role in human health, but is not a major risk factor for all-cause mortality.

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