Association of Helicobacter pylori infection with colorectal adenoma in the Chinese urban population: A cross-sectional study

Objection: Helicobacter pylori (H. pylori) infection is considered to increase the risk of colorectal adenoma (CRA) and remains controversial. In this study, we aimed to evaluate the association between H. pylori infection and CAR in the Chinese urban population. Methods: A cross-sectional study of 301 urban adults, who underwent both screening colonoscopy and 13C urea breath test (13C UBT) from June 2018 to December 2019 at Geriatric Hospital of Nanjing Medical University, was carried out to assess the relationship between H. pylori infection and CRA. All baseline characteristics and laboratory examination of subjects were collected and analyzed by specific personnel. The strength of association between H. pylori infection and the risk of CRA was described by multivariate logistic regression analyses to calculate the odds ratios (ORs) and 95% confidence interval (CIs). Results: Among the 301 subjects, 82 (27.24%) patients with H. pylori positive and 141 (46.84%) were confirmed to have CRA. Multivariate analysis adjusted for age, gender, uric acid and fatty liver revealed that H. pylori infection increased the risk of CRA significantly (adjusted OR 2.007, 95%CI 1.153-3.492, p = 0.014). In addition, the correlation between H. pylori infection and CRA persisted after further adjusting for metabolic variables (adjusted OR 2.029, 95%CI 1.161-3.544, p = 0.013) or other potential confounding factors related to CRA including smoking status, alcohol intake, cholecystitis and gallstone (adjusted OR 1.996, 95%CI 1.141-3.492, p = 0.015). In a gender-based subgroup analysis, H. pylori infection had an increased risk of CRA in male group (adjusted OR 1.997, 95%CI 1.010-3.945, p = 0.047). Conclusions: H. pylori infection had a significant association with the risk of CRA in Chinese urban populations, which will provide new insights into selecting high-risk subjects with CRA.