N Ugwu, E Ugwuja, B Ejikeme, N Obeka
fasting plasma glucose, nigeria, type 2 diabetes
N Ugwu, E Ugwuja, B Ejikeme, N Obeka. Helicobacter pylori Seropositivity in Nigerians with Type 2 Diabetes Mellitus. The Internet Journal of Tropical Medicine. 2007 Volume 4 Number 2.
Background: Data on the relationship between H. pylori infection and diabetes mellitus are scarce and discordant.
Objective: A case-control study has been conducted to investigate the relationship between infection with Helicobacter pylori and type 2 diabetes mellitus in Abakaliki, south eastern Nigeria; a region with high H. pylori endemicity.
Materials & Methods: The study population comprised 60 type 2 diabetics (32 males and 28 females) and 60 non-diabetics (27 males and 33 females) aged 29 to 72 years. Hematological and biochemical parameters were determined using standard techniques while Helicobacter pylori detection in serum was done by an enzyme-linked immunosorbent assay for the identification of immunoglobulin G.
Results: There was no statistically significant difference (p > 0.05) in the prevalence of H. pylori infection and dyspeptic symptoms between diabetics and non-diabetics. Although H. pylori-infected diabetics were significantly older (63.71 vs. 51.95 years; p = 0.00) and had significantly lower fasting plasma glucose (7.96 vs. 11.58 mmol/l; p = 0.01) than the non-infected diabetics, the two groups had comparable hematological and biochemical parameters. Conclusion: H. pylori seropositivity and dyspeptic symptoms were similar in type 2 diabetics and non-diabetics, although H. pylori infection when present in diabetics appears to influence glycaemic status, the mechanism of which remains largely unknown.
Materials And Methods
This study was conducted in Abakaliki at the Ebonyi State University Teaching Hospital (EBSUTH) from May to November 2007. The study area has been previously defined . The Research and Ethics Committee of Ebonyi State University Teaching Hospital, Abakaliki approved the proposal for this study. Participants were known type 2 diabetes mellitus patients on regular management at the Medical Out-patient Clinic of the Department of Internal Medicine, Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. Before enrolment, patients were adequately educated on the need for this study after which willing participant signed written informed consents. At entry into the study each participant was administered with a structured questionnaire to obtain sociodemographic data such as age, sex, level of education, occupation, smoking habits, alcohol intake, duration of diabetes, drug treatment, and symptoms of dyspepsia. Dyspeptic symptoms were regarded as present if the patient complained of any of the following: epigastric pain, bloating, nausea, and vomiting, early satiety, weight loss, GI bleeding or combinations of these symptoms and absent if none was present. Height and weight were measured with the subject in light clothes without shoes, and BMI (Kg/m2) was calculated. In all, a total of sixty (60) patients (32 males and 28 females) aged 29 to 72 years were enrolled. Sixty (60) non-diabetic patients; with fasting plasma glucose ? 6.1mmol/l (27 males and 33 females) matched for age and sex and without family history of diabetes mellitus, not pregnant, or on oral contraceptive pills who were attending the Medical Out-patient Clinic for treatment other than D/M were recruited as controls. Seven milliliters (7ml) venous blood were obtained between 08:00 and 10.00 a.m. after a 12 hour fasting period of which 3ml were dispensed into EDTA bottles for hematological and lipid profile determinations, 2ml into fluoride oxalate bottles for glucose estimation while the remaining 2ml of blood was dispensed into dry glass test tubes for clotting and retraction to take place after which serum were used for total cholesterol determination. Both plasma and serum were obtained after samples were centrifuged at 2000g for five minutes.
Packed cell volume (PCV) and hemoglobin concentration were determined as described in a standard hematology textbook . Fasting plasma glucose was determined by glucose oxidase method as described by Barham and Trinder  using reagent kit from Biosystem Laboratories, Spain. Serum total cholesterol and triglyceride concentrations were determined by enzymatic colorimetric assay as described previously  and modified by Richmond  and HDL-cholesterol and LDL-cholesterol were determined enzymatically in EDTA anticoagulated plasma after precipitation of other lipoprotein as described by Burstein
All statistical analyses were performed with Statistical Package for Social Science (SPSS) 7.5 Data were analyzed for mean and standard deviation. Proportions were expressed as percentage while significant tests were done with the X 2 test. The result was considered significant at p < 0.05.
Table 1 shows the sociodemographic characteristics of diabetic and non-diabetic patients. The two groups were comparable in sex, age, indicators of socioeconomic status except for living accommodation, which was significantly different. The
diabetics have significantly higher BMI than non-diabetics and both groups exhibited significant behavioral difference (alcohol and tobacco consumption).
The diabetics and non-diabetics were significantly different in hematological and biochemical parameters estimated (p < 0.05) except for HDL-cholesterol and triglyceride (table 2).
There was no statistically significant difference in the prevalence of
This study shows a comparable prevalence of
Type 2 diabetes mellitus patients showed no significant difference in
We are grateful to Prof. O Modebe for allowing us to do the study one his patients and to the nurses in the Medical Out-patient Clinic of the Department of Internal Medicine for their cooperation
Ugwuja, E. I. Department of Chemical Pathology, Faculty of Clinical Medicine, Ebonyi State University, P.M.B 053, Abakaliki, Nigeria. E-mail: Ugwuja@yahoo.com Phone: +2347035122010