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Association of CagA-positive Helicobacter pylori infection with severity of obstructive sleep apnea syndrome.

Aim: To investigate the association between Helicobacter pylori cytotoxin-associated gene-A (CagA) status and the severity of OSA syndrome in infected patients.

Methods: Ninty-six patients with obstructive sleep apnea syndrome (OSAS) and 30 age- and sexmatched control subjects with no history of OSA or gastrointestinal complaints were included in the study. Patients’ apnea-hypopnea index (AHI) was determined by polysomnography (PSG), and serum H. Pylori IgG and cytotoxin-associated gene-A IgG was assayed by enzyme-linked immunosorbent assay (ELISA). Based on their AHI score, subjects were assigned to one of three groups: a control group (AHI<5), a mild-moderate OSAS group (AHI ≥ 5 and <30), and a severe OSAS group (AHI ≥ 30).

Results: The prevalence of H. pylori IgG seropositivity was significantly higher in the severe OSAS group compared to the mild-moderate OSAS group [29 (90.6%) patients versus 41 (64%) patients, (p=0.007)]. In addition, CagA seropositivity was present in 10 control patients (58.8%), 23 mildmoderate OSAS patients (56%), and 25 severe OSAS patients (86.2%). There was a significantly higher prevalence of CagA seropositivity in the severe OSAS group compared to mild-moderate OSAS group (p=0.027). There was no significant difference in CagA seropositivity between the mild-moderate OSAS group and the control group (p=0.059).

Conclusion: Our findings suggest that H. pylori strains expressing CagA may be considered a risk factor in the severity of OSAS.

Author(s): Oguzhan Yildirim, Ilhan Bali, Feti Tulubas, Rafet Mete, Birol Topcu, Yuksel Seckin, Yasir Furkan Cagin, Yilmaz Bilgic, Recep Alp