Association of Helicobacter pylori infection with elevated low-density lipoprotein cholesterol and fasting glucose: a large-scale analysis of 83,054 participants in central China

Helicobacter pylori ( H. pylori ) infection is increasingly recognized for its extragastric metabolic effects. However, its specific association with lipid and glucose dysregulation remains controversial. This study aimed to quantify the independent association between H. pylori infection and key metabolic markers, particularly LDL-C and fasting glucose, in a large-scale Chinese cohort. This retrospective cross-sectional study analyzed 83,054 participants from a health management center in a central Chinese city (2021–2025). H. pylori status was determined by the 13 C Urea Breath Test. Multivariable logistic regression was employed to identify independent clinical and metabolic correlates associated with H. pylori positive status, adjusting for age, gender, BMI, and a comprehensive biochemical profile. The overall H. pylori prevalence was 26.55%, with an age-specific peak of 28.80% in the 50–54 cohort. After multivariable adjustment, elevated LDL-C emerged as the strongest independent correlate of H. pylori presence (aOR = 1.34, 95% CI: 1.27–1.41, P < .001). Furthermore, fasting glucose was significantly associated with higher odds of being H. pylori positive (aOR = 1.04, 95% CI: 1.03–1.05, P < .001). In unadjusted analyses, total cholesterol was also significantly higher in the H. pylori-positive group ( P = .005); however, in the multivariable model its independent association was attenuated after adjustment for LDL-C (see Table 2). H. pylori infection is independently associated with elevated LDL-C and fasting glucose in this large urban population. These findings underscore the role of H. pylori as a systemic metabolic stressor and suggest that H. pylori eradication may offer collateral benefits for cardiovascular and metabolic risk management.