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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:427.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Current Infection With Helicobacter pylori, but Not Seropositivity to Chlamydia pneumoniae or Cytomegalovirus, Is Associated With an Atherogenic, Modified Lipid Profile

Albrecht Hoffmeister; Dietrich Rothenbacher; Guenter Bode; Kenneth Persson; Winfried März; Matthias A. Nauck; Hermann Brenner; Vinzenz Hombach; Wolfgang Koenig

From the Departments of Internal Medicine II—Cardiology (A.H., V.H., W.K.) and of Epidemiology (D.R., G.B., H.B.), University of Ulm, Ulm, Germany; the Department of Clinical Microbiology (K.P.), Malmö General Hospital, University of Lund, Malmö, Sweden; and the Division of Clinical Chemistry (W.M., M.A.N.), Department of Medicine, University of Freiburg, Freiburg, Germany.

Correspondence to Prof Dr W. Koenig, Abteilung Innere Medizin II, Medizinische Universitätsklinik, Robert-Koch Strasse 8, D-89081 Ulm, Germany. E-mail wolfgang.koenig{at}medizin.uni-ulm.de

Abstract—Infectious agents may be involved in atherothrombogenesis. The potential pathogenic pathway, however, remains unclear. We investigated the association between various infectious agents and lipoproteins known to have an atherogenic effect. We recruited 470 healthy blood donors and 238 patients with angiographically proven coronary heart disease (CHD), aged 40 to 68 years. Seropositivity to Chlamydia pneumoniae (CP), chlamydial lipopolysaccharide, and cytomegalovirus (CMV) was determined; infection with Helicobacter pylori (HP) was assessed by using the [¹³C]urea breath test. In all subjects, total cholesterol, high density lipoprotein (HDL) cholesterol, lipoprotein(a), and various apolipoproteins (apos) were determined. In unadjusted analysis, mean HDL cholesterol concentration was significantly decreased in HP-positive healthy subjects (1.36 vs 1.44 mmol/L, P=0.006) compared with HP-negative subjects. The HDL cholesterol to total cholesterol ratio was significantly decreased in HP-positive (0.259 vs 0.276, P=0.01) and CP-seropositive (0.266 vs 0.280, P=0.04) healthy subjects compared with (sero)negatives. Mean apoAI levels were significantly lower in HP-positive healthy subjects (1.46 vs 1.51 g/L, P=0.03) and in CMV-positive healthy subjects (1.47 vs 1.52 g/L, P=0.01) compared with (sero)negative subjects. After multivariable adjustment by means of linear regression analysis, only the association between HP infection and decreased HDL cholesterol (P=0.002), decreased HDL cholesterol to total cholesterol ratio (P=0.005), decreased apoAI (P=0.02), and increased apoB (P=0.02) persisted and remained significant. There was no independent association between other lipoproteins and serological markers of CP or CMV infection. Current infection with HP, but not seropositivity to CP or CMV, was associated with an atherogenic, modified lipid profile. These lipid alterations could explain, at least in part, the reported weak association between chronic HP infection and atherosclerotic diseases.

Key Words: lipids • infection • atherosclerosis • coronary heart disease

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