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World J Meta-Anal. Oct 28, 2022; 10(5): 238-243
Published online Oct 28, 2022. doi: 10.13105/wjma.v10.i5.238
Maintaining the metabolic homeostasis of Helicobacter pylori through chronic hyperglycemia in diabetes mellitus: A hypothesis
Vasiliy Ivanovich Reshetnyak, Igor Veniaminovich Maev
Vasiliy Ivanovich Reshetnyak, Igor Veniaminovich Maev, Department of Propaedeutics of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
Author contributions: All the authors have equally contributed to the study conception and design, literature review and analysis, manuscript drafting, critical revision and editing, and approval of the final version.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vasiliy Ivanovich Reshetnyak, MD, MDS, PhD, Full Professor, Department of Propaedeutics of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20, Delegatskaya St., Build. 1, Moscow 127473, Russia. vasiliy.reshetnyak@yandex.ru
Received: August 4, 2022
Peer-review started: August 4, 2022
First decision: August 19, 2022
Revised: August 23, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 28, 2022
Processing time: 84 Days and 20.4 Hours
Abstract

Helicobacter pylori (H. pylori) infection occurs in almost half of the world's population, most of whom are merely carriers of this microorganism. H. pylori is shown to be detected more frequently in patients with diabetes mellitus (DM) than in the general population, which is accompanied by a significantly increased risk of developing H. pylori-associated diseases. In addition, eradication therapy shows a low efficiency for H. pylori infection in patients with DM. There is a relationship between the level of chronic hyperglycemia and a higher detection rate of H. pylori as well as a lower efficiency of eradication therapy in patients with DM. The exact mechanisms of these phenomena are unknown. The authors make a hypothesis that explains the relationship between chronic hyperglycemia and the increased detection rate of H. pylori, as well as the mechanisms contributing to the improved survival of this bacterium in patients with DM during eradication therapy.

Keywords: Helicobacter pylori; Diabetes mellitus; Glycated hemoglobin A; H. pylori eradication; Amino acids and glucose as nutrients for H. pylori

Core Tip: The authors hypothesize that in patients with diabetes mellitus (DM), Helicobacter pylori (H. pylori) are most likely to rely on both amino acids and glucose for its vital activity. The hypothesis makes it possible to explain the high detection rate of H. pylori in patients with DM, as well as the lower efficiency of eradication therapy in them.