Helicobacter pylori infection is associated with an increased risk of chronic obstructive pulmonary disease and asthma.

BACKGROUND

Helicobacter pylori infection, commonly observed in peptic ulcers, induces chronic systemic inflammation. Chronic obstructive pulmonary disease (COPD) and asthma are inflammatory airway diseases. We investigated the association of H. pylori infection with COPD and asthma.

METHODS

Data from individuals who underwent H. pylori eradication treatment between 2009 and 2017 were obtained from the Korean National Health Insurance Database. In total, 33,017 individuals aged ≥ 40 years with H. pylori infection and 168,524 matched controls were identified and monitored until December 2019. Multivariate Cox proportional hazards models were used to estimate the adjusted hazard ratios (aHR) for risk factors associated with COPD and asthma.

RESULTS

The incidences of COPD and asthma among individuals with H. pylori infection were 10.92/1,000 person-years and 15.99/1,000 person-years, respectively. The risk of developing COPD (aHR 1.13, 95% confidence interval [CI] 1.08-1.19) and asthma (aHR 1.17, 95% CI 1.12-1.22) was higher among individuals with H. pylori infection, even after adjusting for smoking status. Subgroup analysis revealed that the risk of COPD was more pronounced among older adults (≥ 65 years) and current smokers. In contrast, the risk for asthma did not differ according to age or smoking status.

CONCLUSIONS

H. pylori infection is associated with an increased risk of COPD and asthma. The risk of asthma was consistent across age groups and smoking statuses; in contrast, the risk of COPD varied. The findings of the present study underscore the pathophysiological interactions between chronic inflammation in the stomach and the lungs.