Association between Helicobacter pylori infection and insulin resistance: Data from the US and Chinese cohorts

Background Helicobacter pylori 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 Helicobacter pylori infection and insulin resistance. Methods This 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. Helicobacter pylori infection was determined using serum antibodies (National Health and Nutrition Examination Survey), 13 C-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. Results In the National Health and Nutrition Examination Survey cohort, Helicobacter pylori positivity was initially associated with a higher triglyceride–glucose index (coefficient = 1.17, p = 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 = 0.900). Similarly, in the Southern China cohort, no significant relationship was found between Helicobacter pylori infection status and the triglyceride–glucose index (coefficient = 0.06, p = 0.689). Conclusions Helicobacter pylori infection is not consistently associated with insulin resistance. Further studies are needed to clarify its role in metabolic diseases.