Association between <i>Helicobacter pylori</i> infection and insulin resistance: Data from the US and Chinese cohorts

Background<i>Helicobacter pylori</i> infection has been associated with diverse extraintestinal morbidities, including cardiometabolic diseases. Insulin resistance is a key pathogenic factor involved in the development of various metabolic diseases. This study aimed to investigate the association between <i>Helicobacter pylori</i> infection and insulin resistance.MethodsThis cross-sectional study analyzed two independent cohorts: 2918 participants from the US National Health and Nutrition Examination Survey (1999-2000) and 912 inpatients from Southern China. <i>Helicobacter pylori</i> infection was determined using serum antibodies (National Health and Nutrition Examination Survey), ¹³C-urea breath test, or rapid urease test (China cohort). Insulin resistance was assessed using the triglyceride-glucose index or homeostasis model assessment of insulin resistance. Multivariate linear regression models were used to analyze the associations.ResultsIn the National Health and Nutrition Examination Survey cohort, <i>Helicobacter pylori</i> positivity was initially associated with a higher triglyceride-glucose index (coefficient = 1.17, p<i> </i>=<i> </i>0.001); however, this association lost statistical significance after full adjustment, and no significant association was observed with the homeostasis model assessment of insulin resistance index (coefficient = 0.03, p<i> = </i>0.900). Similarly, in the Southern China cohort, no significant relationship was found between <i>Helicobacter pylori</i> infection status and the triglyceride-glucose index (coefficient = 0.06, p<i> = </i>0.689).Conclusions<i>Helicobacter pylori</i> infection is not consistently associated with insulin resistance. Further studies are needed to clarify its role in metabolic diseases.