-1. Introduction
Helicobacter pylori, which was originally called Campylobacter pyloridis, is a micro-aerophilic Gram-negative bacillus that is mostly found in the deep parts of the mucous gel covering the gastric mucosa or between the mucus and the gastric epithelium (1). This bacterium can create surface factors that are chemotactic for neutrophils and monocytes and in turn are involved in the damage of epithelial cells. In addition to this, the host's inflammatory response to Helicobacter pylori includes the call of neutrophils, lymphocytes (B, T), macrophages, and plasma cells. The pathogen causes local damage and apoptotic cell death by binding to MHC class II molecules located on the surface of gastric epithelial cells. to be In addition, bacterial strains that encode Cag-PAI can introduce Cag A to host cells and lead to more cell damage and activation of cell pathways involved in steokine production. Increased concentration of several steokines has been found in the gastric epithelium of people infected with Helicobacter pylori, these steokines include interleukin a/b (IL), IL-2, IL-61, IL-8, tumor necrosis factor ?. (TNF-?) and interferon gamma (1 and 3). In addition, Helicobacter pylori infection leads to a general mucosal and humoral response, which does not lead to the eradication of the bacteria, but makes epithelial cell damage more complicated (1). stomach MAIT)) but today it has been determined that this microorganism is also associated with manifestations outside the digestive tract (4).
Information about the connection of this infection with cardiovascular diseases, neurological manifestations, diabetes mellitus, immunological and hematological diseases, diseases of the liver and bile ducts, diseases of the respiratory tract and the gynecological system is at hand, henceforth the most convincing evidence is available in the association of this microorganism with anemia There are idiopathic sideroblastic and autoimmune thrombocytopenic purpura. There is new information about the relationship between these ischemic heart diseases and Helicobacter pylori, although there are things that need to be clarified and more evidence is needed about the relationship of this microorganism with other diseases (5). Studies have not shown a relationship between this infection and insulin resistance (6, 7), but in other studies, a relationship between this infection and insulin resistance has been observed (4, 8, 9, 10). Despite these differences, it seems that there is a need for more studies to investigate the relationship between Helicobacter pylori and insulin resistance. If the relationship between this microorganism and insulin resistance is fully proven in the future, a new window may be opened in understanding the pathophysiology and treatment of diseases in which insulin resistance is involved, such as type 2 diabetes mellitus and nonalcoholic fatty liver disease. In this study, which was designed by us, we intend to investigate the relationship between Helicobacter pylori infection and the level of insulin resistance in diabetic patients. Let's do it.
2-1. Objectives of the study
1-2-1. The main objective of the project: (General objective)
Comparison of insulin resistance in diabetic patients with and without Helicobacter pylori
2-2-1.. Sub-objectives of the project: (Specific objective)
Determining the prevalence of insulin resistance in people with Helicobacter pylori infection in diabetic patients
Determining the prevalence of insulin resistance in people without Helicobacter pylori infection in diabetic patients
Determining the prevalence of age, sex and duration of diabetes in people with Helicobacter pylori infection in diabetic patients
Determining the prevalence of age, sex and duration of diabetes in people without Helicobacter pylori infection in diabetic patients
Determining the BMI of people with Helicobacter pylori infection in diabetic patients
Determining the BMI of people without infection Helicobacter pylori in diabetic patients
Determination of fasting blood sugar and insulin in people with Helicobacter pylori infection in diabetic patients
Determination of fasting blood sugar and insulin in people without Helicobacter pylori infection in diabetic patients
3-1. Hypotheses-questions:
Hypothesis:
The level of insulin resistance in diabetic patients with and without Helicobacter pylori is different.
Questions:
Prevalence of insulin resistance in people with infection What is the prevalence of Helicobacter pylori in diabetic patients?
What is the prevalence of insulin resistance in people without Helicobacter pylori infection in diabetic patients?
What is the average age of people with Helicobacter pylori infection in diabetic patients?
The average age of people without infection How much is Helicobacter pylori in diabetic patients?
What is the sexual prevalence of people with Helicobacter pylori infection in diabetic patients?
What is the sexual prevalence of people without Helicobacter pylori infection in diabetic patients?
The average duration of diabetes in infected people How much is Helicobacter pylori in diabetic patients?
What is the average duration of diabetes in people without Helicobacter pylori infection in diabetic patients?
What is the average BMI of people with Helicobacter pylori infection in diabetic patients?
Average BMI of people without infection How much is Helicobacter pylori in diabetic patients?
What is the average fasting blood sugar and insulin in diabetic patients with Helicobacter pylori infection?
What is the average fasting blood sugar and insulin in diabetic patients without Helicobacter pylori infection?
4-1. Definition of words
1- Widespread inflammation: a condition that is reflected by an increase in circulating acute phase reactants such as inflammatory cytokines and reactive proteins (CRP) and also by a corresponding decrease in negative acute phase reactants such as albumin and fetin.
2- Helicobacter pylori: a gram-negative bacillus that is mostly found in the deep part of the gastric mucosal gel. and causes gastritis.
3- Serology test: examination of Helicobacter pylori antibody in the patient's serum sample by ELISA method
4- Diabetes: includes a group of common metabolic disorders that have a common feature in the hyperglycemic phenotype.
5- Insulin resistance: resistance to insulin, reduced ability of insulin to act effectively on It is on the target tissues (especially muscle, liver, and fat) and it is a characteristic of type 2 diabetes, which is caused by obesity and genetic predisposition.
5-1. Limitations of the research:
Among the limitations was the high cost of this study, which was largely resolved with the assistance of Qom University of Medical Sciences, and on the other hand, some patients were not satisfied with participating in this study, and the last problem was the referral of patients for tests, which was resolved by performing them in the laboratory of Shahid Beheshti Hospital.
-2 diabetes type 2
Resistance to Insulin and abnormal insulin secretion play a major role in the development of type 2 diabetes.