Association Between Helicobacter pylori Infection and Metabolic Disturbances in U.S. Women: A National Cross-Sectional Study

Background: The association between Helicobacter pylori ( H. pylori ) infection and metabolic disturbances remains inconsistent across existing studies. Given potential sex-specific differences in metabolic regulation, this study specifically examined the relationship between H. pylori infection and hypertension, glucose metabolism, and lipid profiles in women. Methods: We analyzed data from the 1999 to 2000 National Health and Nutrition Examination Survey. Participants were excluded if they were male, pregnant, had missing data, or had indeterminate H. pylori IgG results. Women were categorized as seronegative and seropositive based on antibody levels. Group characteristics were compared, and multivariable logistic regression was used to identify determinants of seropositivity. Results: Among 539 women, H. pylori seroprevalence was 41.37%. Independent predictors of seropositivity included elevated hemoglobin (HbA1c) (odds ratio [OR] = 1.75, 95% confidence interval [CI]: 1.11–2.76), older age (OR = 1.02 per year, 95% CI: 1.01–1.04), and lower educational attainment (OR = 0.60, 95% CI: 0.51–0.71). A significant dose-response relationship was observed between HbA1c and H. pylori infection risk ( p for trend = 0.005). Women in the highest HbA1c quartile (Q4) had 2.14-fold higher odds of infection (95% CI: 1.25–3.67) compared to those in the lowest quartile (Q1). Restricted cubic spline analysis revealed a nonlinear association between HbA1c and H. pylori infection risk ( p for nonlinearity <0.001). Conclusion: Elevated HbA1c levels, rather than other metabolic indicators or blood pressure, are significantly and dose-dependently associated with H. pylori infection risk in U.S. women.