ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1589510
Association between Helicobacter pylori seropositivity and the hemoglobin A1c/High-density lipoprotein cholesterol ratio in U.S. Adults: Evidence from NHANES
Provisionally accepted
- 1Nanjing University of Chinese Medicine, Nanjing, China
- 2Affiliated Hospital of Nanjing University of Chinese Medicine,, Nanjing, China., China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Helicobacter pylori (H. pylori) infection is associated with insulin resistance and metabolic syndrome. This study investigates the association between H. pylori seropositivity and the newly proposed hemoglobin A1c/high-density lipoprotein cholesterol ratio (HbA1c/HDL-C ratio) in a nationally representative U.S. population.Methods: Data from the 1999-2000 National Health and Nutrition Examination Survey (NHANES) were analyzed. Multivariable linear regression models assessed the association between H. pylori seropositivity and the HbA1c/HDL-C ratio. Subgroup analyses were performed to evaluate the consistency of the association across different demographic and clinical strata. Generalized additive models with smoothing splines and threshold effect analysis was conducted to identify potential nonlinear relationships. Results: The cross-sectional analysis comprised 2,909 participants, including 1,294 with H. pylori seropositivity. After multivariable adjustment, a significant positive association was found between H. pylori seropositivity and the HbA1c/HDL-C ratio (β: 0.28, 95% CI: 0.13, 0.42). Subgroup analyses revealed a stronger association among non-diabetic individuals compared to diabetic individuals. A “L”-shaped relationship was observed, with an inflection point at an HbA1c/HDL-C ratio of 4.81. Below this threshold, H. pylori seropositivity was positively associated with the HbA1c/HDL-C ratio. Above this threshold, the association was no longer statistically significant. Conclusion: This study identifies a significant association between H. pylori seropositivity and the HbA1c/HDL-C ratio, suggesting that metabolic dysfunction may be linked to H. pylori infection. Future longitudinal studies are needed to establish causality and explore underlying mechanisms.
Keywords: Helicobacter pylori, hemoglobin A1c/high-density lipoprotein cholesterol ratio, metabolic dysfunction, NHANES, Cross-sectional study
Received: 07 Mar 2025; Accepted: 23 May 2025.
Copyright: © 2025 Xu, Jiang, Liao, Zhao, Hu and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Cheng Xu, Nanjing University of Chinese Medicine, Nanjing, China
Hong Shen, Affiliated Hospital of Nanjing University of Chinese Medicine,, Nanjing, China., China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.