Association between Helicobacter pylori infection and dyslipidemia: Evidence from observational studies and Mendelian randomization Analysis - 10/03/26

Doi : 10.1016/j.clinre.2026.102804

Fen Ren ¹, Caizheng Yang ^2,^⁎ , Hongwei Wang ³, Jinli Guo ⁴, Yan Wang ⁵, Lu Bai ^3,^⁎

¹ Shanxi Medical University, No 56, Xinjian South Road, Yingze District, Taiyuan 030000, China

² College of nursing, Shanxi Technology and Business University, No. 99, Wucheng South Road, Xiaodian District, Taiyuan 030000, China

³ Department of Drug clinical trial institution, Shanxi Provincial People's Hospital, No. 26, Dongjie Street, Shuangta Temple, Taiyuan 030012, China

⁴ Department of education, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Taiyuan 030000, China

⁵ Department of Clinical Laboratory, The Fourth People's Hospital of Taiyuan, 269 No. 231, Xikuang Street, Wanberlin District, Taiyuan 030000, China;

^⁎ Corresponding author: Lu Bai

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Tuesday 10 March 2026

Highlights

•	Longitudinal cohort study was used to dynamically track the correlation between disease indicators and avoid the limitation of cross-sectional study.
•	Combined with Mendel randomization analysis, it can reduce the interference of confounding factors and provide strong evidence for causality.
•	The two methods confirm each other, improve the reliability of the conclusion and provide reference for clinical prevention and intervention.
•	It is of great significance for public health to focus on the potential relationship between them and fill the gap in related research.

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Abstract

Background

Helicobacter pylori ( H. pylori ) infection is highly comorbid with dyslipidemia. This study investigated their association using longitudinal trajectory analysis and Mendelian randomization (MR).

Methods

2433 individuals undergoing annual health examinations (2018-2021) were enrolled. Group trajectory modeling categorized subjects based on C14 breath test results into normal group, slow infection group and persistent infection group. Dyslipidemia incidence was tracked from 2022-2023. Log-rank tests compared incidence, and logistic regression calculated odds ratios (OR) with 95% confidence intervals (CI). Two-sample MR used H. pylori antibody GWAS data and UK Biobank dyslipidemia GWAS. Inverse Variance Weighted (IVW) was the primary method, supplemented by sensitivity analyses.

Results

Three trajectories were identified. The incidence of dyslipidemia in slow infection group(23.2%) and persistent infection group (27.5%) was significantly higher than that in normal group (15.4%; P < 0.05). After adjustment, compared with the normal group, the risk of dyslipidemia in the slow infection group and the persistent infection group increased by 0.759 times (95% CI : 0.541–1.066, P =0.012) and 1.752 times (95% CI : 1.169–2.625, P = 0.007) . MR analysis (IVW) showed H. pylori GroEL antibody levels significantly correlated with total cholesterol and HDL levels, and VacA antibody levels correlated with triglycerides ( P < 0.05). Sensitivity analyses confirmed no heterogeneity or horizontal pleiotropy.

Conclusions

Both longitudinal and MR analyses consistently demonstrate a significant association between persistent H. pylori infection and increased dyslipidemia risk. Further research into the underlying mechanisms is warranted to understand H. pylori's extragastric effects.

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