Study on the correlation between serum Th1/Th2 balance and the risk of osteoporosis in patients with helicobacter pylori infection

Abstract

This study aimed to investigate the correlation between serum T helper 1/T helper 2 (Th1/Th2) balance and the risk of osteoporosis (OP) in patients with Helicobacter pylori (Hp) infection. All patients were tested for both Hp and bone mineral density (BMD). A total of 200 patients were categorized into Hp non-infected ( n = 100) and Hp infected ( n = 100) groups based on 14 C urea breath test results. Subsequently, patients were further divided into non-OP ( n = 110) and OP ( n = 90) groups according to BMD measurements. Serum levels of interferon-γ (IFN-γ) and interleukin-4 (IL-4) were measured to calculate the IFN-γ/IL-4 ratio, reflecting the Th1/Th2 balance. Bone metabolism markers, bone alkaline phosphatase (BALP) and bone gal protein (BGP), were also assessed. The Hp infected group exhibited significantly lower BMD (0.97 vs. 1.02 g/cm², P = 0.024), higher BALP (19.28 vs. 18.25 µg/L, P = 0.026), lower BGP (17.35 vs. 18.91 µg/L, P = 0.017), a higher IFN-γ/IL-4 ratio (18.26 vs. 15.87, P < 0.001), and a higher OP prevalence (54% vs. 36%, P = 0.011) compared to the non-infected group. The OP group had a higher IFN-γ/IL-4 ratio (18.09 vs. 16.23, P < 0.001). Correlation analysis revealed that OP risk positively correlated with the IFN-γ/IL-4 ratio ( r = 0.313), IFN-γ ( r = 0.212), age ( r = 0.160), and smoking ( r = 0.170), and negatively with male ( r =-0.159, all P < 0.05). Multivariate analysis identified the IFN-γ/IL-4 ratio as an independent risk factor for OP (OR = 1.257, P < 0.001). Hp infection may be associated with an increased risk of OP, potentially mediated by a shift towards a Th1-dominant immune response.