Гастрит и инфекция H. pylori повышают риск развития болезни Паркинсона

Helicobacter pylori (H pylori) infection and gastritis are associated with a modestly increased risk for developing Parkinson disease (PD), according to findings published in the Journal of Parkinson’s Disease. Researchers conducted a nationwide, population-based matched cohort study using data from the Swedish Epidemiology Strengthened by HistoPathology Reports in Sweden (ESPRESSO) cohort to evaluate the associations of biopsy-confirmed H pylori infection, gastritis, and peptic ulcer with subsequent PD risk. Adults with biopsy-confirmed H pylori infection, gastritis, or peptic ulcer diagnosed between 1987 or 1990 and 2017 were each matched with up to 5 biopsy-free individuals from the general population according to age, sex, calendar year, and county of residence. Participants were followed through December 2021 for incident PD. Multivariable Cox proportional hazards models were adjusted for country of birth, educational attainment, chronic obstructive pulmonary disease (COPD), and prior health care utilization. Future studies are needed to clarify whether the associations we found reflect a true causal relationship, prodromal PD symptoms, or shared underlying mechanisms influencing both gastrointestinal impairment and neurodegeneration. The matched cohorts comprised more than 1.9 million participant records. The H pylori cohort comprised 48,258 participants with biopsy-confirmed H pylori infection and 231,805 matched referents. The peptic ulcer cohort included 52,761 participants with biopsy-confirmed peptic ulcer and 274,313 matched referents. The gastritis cohort included 242,325 participants with biopsy-confirmed gastritis and 1,053,688 matched referents. Women accounted for approximately one-half of participants in each cohort, mean age ranged from 63.3 years in the H pylori cohort to 69.0 years in the peptic ulcer cohort, and median follow-up ranged from 6.7 to 9.3 years. Compared with matched referents, participants with biopsy-confirmed H pylori infection, peptic ulcer, or gastritis generally had more COPD diagnoses and a greater number of specialist health care visits before study entry. During follow-up, the researchers identified 2283 incident PD diagnoses in the H pylori cohort, 4214 in the peptic ulcer cohort, and 14,369 in the gastritis cohort. Incident PD rates per 1000 person-years were 1.0 among participants with H pylori infection compared with 0.9 among matched referents, 1.3 vs 1.2 among those with peptic ulcer, and 1.1 vs 1.0 among those with gastritis. After adjustment for potential confounders, biopsy-confirmed H pylori infection was associated with a modest increase in PD risk (hazard ratio [HR], 1.14; 95% CI, 1.02-1.28). A similar association was observed among participants with gastritis (HR, 1.14; 95% CI, 1.09-1.19), whereas peptic ulcer was not significantly associated with subsequent PD (HR, 1.08; 95% CI, 0.98-1.19). Time-dependent analyses showed that the association between gastritis and PD was strongest during the first 2 years after diagnosis (HR, 1.28; 95% CI, 1.16-1.41). Although the magnitude of the association declined over time, the elevated risk remained statistically significant during years 2 to 5 (HR, 1.16; 95% CI, 1.06-1.27) and years 5 to 10 (HR, 1.14; 95% CI, 1.05-1.25) before no longer reaching statistical significance after 10 years. By comparison, the associations for H pylori infection and peptic ulcer did not vary over time. The researchers also found that higher educational attainment and being born outside Sweden were associated with greater PD risk, particularly within the gastritis cohort. Conversely, COPD was inversely associated with PD across all 3 cohorts. A higher number of health care encounters before study entry was associated with increased PD risk among participants with gastritis and peptic ulcer but not among those with H pylori infection. Sensitivity analyses restricted to primary PD diagnoses produced similar findings for gastritis, whereas the associations for H pylori infection and peptic ulcer were attenuated. Study limitations include potential exposure misclassification due to reliance on biopsy-confirmed diagnoses, residual confounding from unmeasured lifestyle factors, registry-based PD diagnoses, and the inability to fully exclude surveillance bias or reverse causation. “Future studies are needed to clarify whether the associations we found reflect a true causal relationship, prodromal PD symptoms, or shared underlying mechanisms influencing both gastrointestinal impairment and neurodegeneration,” the study authors concluded. Disclosures: This research was supported by the Swedish Research Council, the Swedish government– county council ALF agreement, the Swedish Parkinson Foundation, Karolinska Institutet, and Region Stockholm. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. References: Licaj S, Ploner A, Szwajda A, et al. Helicobacter pylori infection, peptic ulcer, gastritis and risk of Parkinson’s disease: a nationwide matched cohort study. J Parkinsons Dis. 2026;0(0). doi:10.1177/1877718X261466875