First-line Helicobacter pylori eradication rates are significantly lower in patients with than those without type 2 diabetes mellitus

Figures & data

Table 1 Baseline characteristics of patients with and without DM

	Before PSM			After PSM for age, sex, BMI
	DM group N=182 (%)	Control N=537 (%)	P-value	DM group N=147 (%)	Matched control N=279 (%)	p-value
Age (years)	64.1±9.0	58.3±12.2	<0.001	63.2±8.9	63.9±10.3	0.401
Sex (male); n (%)	87 (47.8)	270 (50.3)	0.564	68 (46.3)	126 (45.2)	0.829
Body weight (kg)	68.9±12.6	64.4±13.1	<0.001	69.3±12.9	67.3±12.7	0.119
BMI; mean ± SD	26.0±3.9	24.3±4.2	<0.001	26.0±3.9	25.5±3.9	0.203
Previous history of peptic ulcer	39 (21.4)	101 (18.8)	0.440	31 (21.1)	60 (21.5)	0.920
Alcohol; n (%)	23 (12.6)	83 (15.5)	0.354	21 (14.3)	49 (17.6)	0.386
Smoking; n (%)	24 (13.2)	76 (14.2)	0.745	22 (15.0)	41(14.7)	0.940
Diabetes duration (years)	8.1±5.9	NA		7.9±5.9	NA
Diabetes treatment; n (%)
No treatment	26 (14.3)	NA		25 (17.0)	NA
Oral antihyperglycemic drug	147 (80.8)			116 (78.9)
Insulin monotherapy	3 (1.6)			2 (1.4)
Combination therapy	6 (3.3)			4 (2.7)
Low-density lipoprotein (mg/dL)	101.7±31.7	108.7±31.7	0.032	103.6±32.9	106.8±31.8	0.416
Triglycerides (mg/dL)	148.4±83.8	124.8±75.4	0.003	153.5±88.5	135.3±8 4.0	0.077
GFR (ml/min/1.73 m^2)	77.6±29.0	84.8±24.6	0.003	78.2±27.6	81.0±24.4	0.330

Abbreviations: PSM, propensity score matching; DM, diabetes mellitus; SD, standard deviation; BMI, body mass index; GFR, glomerular filtration rate; NA, no analysis.

Table 2 Major outcomes of H. pylori eradication therapy

Eradication rate	DM group	Control	p-value
Patients, % (n) Before matching	75.3% (137/182)	84.4% (453/537)	0.006
Patients, % (n) After matching	74.1% (109/147)	85.3% (238/279)	0.005

Abbreviation: DM, diabetes mellitus.

Table 3 Adverse events of the H. pylori treatment regimen after matching

	DM group N=147 (%)	Matched control N=279 (%)	p-value
Skin rash	0	0	-
Abdominal pain	2 (1.4)	4 (1.4)	0.951
Constipation	2 (1.4)	5 (1.8)	0.739
Loose stool	2 (1.4)	7 (2.5)	0.433
Dizziness	0	3 (1.1)	0.207
Headache	0	1 (0.4)	0.467
Nausea	1 (0.7)	2 (0.7)	0.966

Abbreviation: DM, diabetes mellitus.

Table 4 Univariate analysis of factors associated with failure of H. pylori eradication

Variants	Comparison	Univariate OR (95% CI)	p-value
Age	Per 1-year increment	0.999 (0.983–1.015)	0.877
Sex	Male vs female	1.301 (0.887–1.908)	0.177
BMI	Per 1 kg/m^2 increment	0.997 (0.951–1.045)	0.894
Previous history of ulcer	Yes vs no	0.949 (0.589–1.528)	0.829
Alcohol	Yes vs no	1.202 (0.663–2.177)	0.545
Smoking	Yes vs no	1.065 (0.575–1.971)	0.841
Comorbidity
Diabetes	Yes vs no	1.771 (1.167–2.668)	0.006
Hypertension	Yes vs no	1.151 (0.769–1.724)	0.496
Coronary artery disease	Yes vs no	0.730 (0.321–1.661)	0.453
Cerebrovascular accident	Yes vs no	1.870 (0.711–4.916)	0.204
Chronic kidney disease	Yes vs no	0.985 (0.576–1.686)	0.957
Dyslipidemia	Yes vs no	1.489 (0.962–2.307)	0.074
H. pylori culture (n=41)
Clarithromycin resistance	Yes vs no	15.273 (1.687–138.269)	0.015
Amoxicillin resistance	Yes vs no	4.672 (2.431–8.979)	<0.001

Note: Factors with a P-value less than 0.3 were entered into logistic regression analysis.

Abbreviation: BMI, body mass index.

Table 5 Multivariate analysis of the clinical factors associated with failure of H. pylori eradication

Clinical factor	Coefficient	Standard error	Odds ratio (95% CI)	p-value
Clarithromycin resistance	3.238	1.429	25.472 (1.549–418.956)	0.023

Abbreviation: CI, confidence interval.