Prevalence and predictors of Helicobacter pylori infection in asymptomatic individuals: a hospital-based cross-sectional study in Shenzhen, China

Although a high Helicobacter pylori infection rate has been reported in dyspeptic patients, published data for the asymptomatic population are inadequate. We aimed to investigate the prevalence of H. pylori infection and the association between H. pylori infection diagnosed using the noninvasive 13C urea breath test (13C UBT) and risk factors in asymptomatic Chinese individuals.Healthy subjects who underwent hospital health examinations in the hospital health management department from September 2020 to September 2021 were consecutively enrolled. Anthropometric and biochemical characteristics were measured, and all subjects underwent 13C UBT. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection.Of the 5007 participants included, the overall prevalence of H. pylori infection was 35.0% and was similar in men (35.5%) and women (34.2%). The prevalence of H. pylori increased by 84.8% in those aged ≥ 60 years compared with those aged < 30 years (P=0.006), and increased by 30.9% in the obese group compared with the normal weight groups (P = 0.034). Fasting blood glucose (FBG) and albumin levels showed a significant association with the prevalence of H. pylori. The prevalence of H. pylori increased by 6.9% following each 1-unit increase in FBG (P = 0.033) and decreased by 3.7% for each 1-unit increase in albumin (P = 0.012). Moreover, the results of the age stratification showed that albumin level was negatively associated with the prevalence of H. pylori in participants aged < 50 years (OR = 0.952, 95%CI: 0.921-0.985; P = 0.005). However, the prevalence of H. pylori in participants aged ≥ 50 years increased by 66.6% in the impaired glucose group compared to the normal glucose group (P = 0.003).These findings suggest that detailed and strict weight and glucose management is crucial to reduce the prevalence of H. pylori infection. Management strategies should be identified and implemented with regard to these identified factors to reduce the notable economic and healthcare burden in China.