The relationship between updated Sydney System score and LDL cholesterol levels in patients infected with Helicobacter pylori.

OBJECTIVES: Helicobacter pylori (H. pylori) chronically infects the human stomach and may cause extra-gastrointestinal diseases. The role of H. pylori in the pathogenesis of atherosclerosis and its effect on lipids remains controversial. The aim of this study was to examine lipid levels in patients with and without H. pylori infection. METHODS: A total of 244 consecutive patients who underwent esophagogastroduodenoscopy were included in this study. Patients receiving statin and fibrate therapy and diabetic patients were excluded. Biopsies from each individual were taken and analyzed for H. pylori detection using ultrastructural methods. Patients were divided into two groups: H. pylori (+) (group 1) and H. pylori (-) (group 2). Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were measured in all subjects. RESULTS: A total of 163 patients were included in group 1 and 81 patients were included in group 2. Frequency of H. pylori was 67% in the study population. Total cholesterol (204 +/- 39 mg/dl versus 189 +/- 42 mg/dl, respectively; P = 0.007) and LDL-C (128 +/- 30 mg/dl versus 116 +/- 32 mg/dl, respectively; P = 0.003) were significantly higher in group 1 than in group 2. Updated Sydney classification score showed a positive correlation with LDL-C (r = 0.333, P < 0.001) and TC (r = 0.288, P < 0.001) levels. CONCLUSION: Increased levels of TC and LDL-C were found in patients infected with H. pylori, and updated Sydney System score showed a positive correlation with LDL-C and TC levels. These findings may explain why H. pylori infection is associated with increased risk of atherosclerosis.

Hashimoto's thyroiditis is a frequent occurrence in patients with rheumatic mitral stenosis.

BACKGROUND AND AIM OF THE STUDY: Rheumatic mitral stenosis (RMS), an autoimmune sequel of streptococcal infection, causes significant morbidity and mortality. As Hashimoto's thyroiditis (HT) is recognized as the major form of chronic autoimmune thyroiditis, it was hypothesized that the coexistence of HT and RMS might have an autoimmune origin. The study aim was to examine this possible relationship. METHODS: A total of 55 consecutive patients with RMS was examined and compared to 54 healthy controls with normal echocardiographic findings. All subjects underwent transthoracic echocardiography and thyroid ultrasonography after a complete medical history and laboratory examination. RESULTS: The demographic data of the RMS group (38 females, 17 males; mean age 39.9 +/- 9.3 years) and control group (39 females, 15 males; mean age 39.6 +/- 10.5 years) were similar. HT was found to occur significantly more frequently in RMS patients (n = 16; 29%) than in controls (n = 6; 11%) (p = 0.019) CONCLUSION: The higher frequency of HT in patients with RMS than controls may have genetic associations. Hence, further genetic-based studies should be conducted to provide a better understanding of this suggested relationship.

Cardiac repolarization abnormalities and increased sympathetic activity in scleroderma.

BACKGROUND: Cardiac involvement in scleroderma is a poor prognostic sign and is usually underdiagnosed, particularly in asymptomatic patient. This paper focuses on QT dynamicity and heart rate variability (HRV) in patients with scleroderma and controls in an attempt to investigate the cardiac autonomic system and ventricular repolarization. METHODS: Sixty patients with scleroderma and 30 age- and sex-matched healthy controls who had no cardiovascular risk factors were included in this study. All patients and the controls underwent a 24-hour holter recording as well as a transthoracic echocardiography. HRV and QT dynamicity parameters were calculated. RESULTS: In HRV analysis, autonomic balance was changed in favor of the sympathetic system in patients with diffuse scleroderma. In QT dynamicity analysis, QT/RR slopes were significantly steeper in patients with diffuse scleroderma compared to patients with limited scleroderma and controls (QTapex/RR: 0.24 +/- 0.16, 0.15 +/- 0.03, 0.14 +/- 0.03 respectively p < 0.001; QTend/RR: 0.26 +/- 0.17, 0.14 +/- 0.04, 0.13 +/- 0.05, respectively p < 0.001). CONCLUSIONS: Patients with diffuse scleroderma may have asymptomatic cardiac repolarization abnormalities and autonomic dysfunction. Our results may indicate that QT dynamicity and HRV can be useful noninvasive methods that may detect impaired state of autonomic balance and cardiac repolarization in patients with diffuse scleroderma.