Helicobacter pylori infection and the hypothalamic-pituitary axis: association with cortisol and thyroid-stimulating hormone levels in adults.

IF 1.9 Q4 MICROBIOLOGY

Iranian Journal of Microbiology Pub Date : 2026-06-01 DOI:10.18502/ijm.v18i3.21653

Nedaa Husein, Muna M Abbas, Dania Basha, Dima Tareq Owais, Nameer Amer Hanineh-Halasa

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Abstract

Background and objectives: Helicobacter pylori is a common chronic bacterial infection primarily associated with gastrointestinal disease. Increasing evidence suggests that H. pylori may also exert systemic effects beyond the stomach, including possible modulation of neuroendocrine pathways. This study aimed to investigate the association between H. pylori infection and alterations in serum cortisol and thyroid-stimulating hormone (TSH) levels as indicators of hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis activity.

Materials and methods: In this case-control study, 850 adults were enrolled, including 425 H. pylori-positive cases and 425 H. pylori-negative controls. Active H. pylori infection was determined using a monoclonal stool antigen test (HpSA). Fasting venous blood samples were collected between 08:00 and 10:00 AM under standardized conditions. Serum cortisol and TSH levels were measured using validated immunoassays. Group comparisons, correlation analysis, sex-stratified subgroup analysis, and receiver operating characteristic (ROC) curve analysis were performed.

Results: H. pylori-positive participants had significantly higher serum cortisol levels and lower TSH levels compared with controls (both p < 0.001). A significant inverse correlation between cortisol and TSH was observed only in infected participants (r = -0.41, p < 0.001). These hormonal alterations were evident in both sexes. ROC analysis showed moderate discriminatory performance for cortisol (AUC = 0.71) and fair-to-moderate performance for TSH (AUC = 0.67).

Conclusion: H. pylori infection was significantly associated with elevated cortisol levels, reduced TSH levels, and an inverse relationship between both hormones in adults. These findings suggest that chronic H. pylori infection may influence both HPA and HPT axis regulation and support further investigation into its systemic neuroendocrine effects.

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幽门螺杆菌感染与下丘脑-垂体轴：与成人皮质醇和促甲状腺激素水平的关系

背景和目的：幽门螺杆菌是一种常见的慢性细菌感染，主要与胃肠道疾病有关。越来越多的证据表明，幽门螺旋杆菌也可能对胃以外的系统产生影响，包括可能调节神经内分泌途径。本研究旨在探讨幽门螺杆菌感染与作为下丘脑-垂体-肾上腺（HPA）和下丘脑-垂体-甲状腺（HPT）轴活性指标的血清皮质醇和促甲状腺激素（TSH）水平变化之间的关系。材料和方法：在这项病例对照研究中，纳入了850名成年人，包括425名幽门螺杆菌阳性病例和425名幽门螺杆菌阴性对照。采用单克隆粪便抗原试验（HpSA）检测活动性幽门螺杆菌感染。在标准化条件下，于08:00 - 10:00 AM采集空腹静脉血。血清皮质醇和TSH水平采用有效的免疫分析法测量。进行分组比较、相关分析、性别分层亚组分析、受试者工作特征（ROC）曲线分析。结果：与对照组相比，幽门螺杆菌阳性受试者血清皮质醇水平显著升高，TSH水平显著降低（均p < 0.001）。皮质醇和TSH之间的显著负相关仅在感染参与者中观察到（r = -0.41, p < 0.001）。这些荷尔蒙变化在两性中都很明显。ROC分析显示，皮质醇的区分表现为中等（AUC = 0.71）， TSH的区分表现为中等（AUC = 0.67）。结论：幽门螺杆菌感染与成人皮质醇水平升高、TSH水平降低显著相关，两者呈反比关系。这些结果表明，慢性幽门螺杆菌感染可能影响HPA和HPT轴的调节，并支持进一步研究其系统神经内分泌作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Microbiology MICROBIOLOGY-

CiteScore

2.40

自引率

7.10%

发文量

审稿时长

12 weeks

期刊介绍： The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.