Relationship between helicobacter pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia

Relationship between helicobacter pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Relationship between helicobacter pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia Belay Zawdie, Kalkidan Hassen Abate, Solomon Tesfaye, Aklesya Enkobahry, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5237619/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Infection with H. Py lori triggers chronic inflammatory states along with dyslipidemia contribute of atherosclerosis. However, there is lack of emerging evidences of relationship of H. pylori infections and dyslipidemia among healthy adults. Therefore, this study aimed to investigate the relationship between H. pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia. A total of 865 asymptomatic adults aged > 18 years were enrolled in the study. From each study participants, 24-hrs dietary re-call, Rome-III based criteria abdominal pain symptoms, 5ml of venous blood and 20g of fresh stool was collected. From the study participants, positive H. pylori infection was, 170(19.7%) whereas dyslipidemia incidence was, 108(12.5). Factors significantly associated with the H. pylori positive test with an AOR (95% CI, p < 0.05) were chewing khat, less physical activity, dyslipidemia, being hypertensive, central obesity and functional dyspepsia as compared to their normal counterparts. However, H. pylori infection was not associated with any of the dietary diversity scores. H. pylori infection is detected among asymptomatic population living in our study area. Moreover, H. pylori infection is significantly associated with dyslipidemia. Therefore, early screening and decreasing the risk factors are highly recommendable. H. pylori Lipid profile dyslipidemia Jimma city Ethiopia Figures Figure 1 Figure 2 Introduction Helicobacter pylorus (H. pylorus) is gram-negative pathogenic bacterium that causes acute and chronic gastro-duodenal diseases ( 1 ). H. pylori infection affects more than 80% of the populations in developing countries ( 2 ). Similarly, the prevalence of H. pylori infection in Ethiopia oscillated from 7.7–91% ( 3 , 4 ). Moreover, in developing countries, H. pylori infections and its associated diseases are usually occurring at earlier ages ( 5 ). On the other hand, dyslipidemia which is highly associated with advanced age brings implications inside the cardiovascular system leads to vascular coronary disease and atherosclerosis; and its co-occurrence with H. pylori infection shows the possible alteration of the serum lipid profile ( 6 ). Evidence showed as H. pylori infection along dyslipidemia, impaired glucose metabolism and endothelial dysfunction; contributed in pathogenesis of atherosclerosis ( 7 ). Likewise, there is a positive relation between cytotoxic associated gene-A (Cag A) positive strain of H. pylori and vascular diseases ( 8 ). Furthermore, there are evidences potentially suggesting the possible association between H. pylori infection and vitamin B12 deficiency that has been leading to extra gastric clinical signs accelerates alteration of total cholesterol, triglycerides, LDL-c, and HDL-c ( 9 , 10 , 11 , 12 ). In Ethiopia, studies indicated that more than half of Ethiopians were chronically infected with H. pylori ( 13 ) and its impacts on metabolic syndrome and serum lipid profile alteration ( 14 , 15 , 16 ). Despite the fact that H. pylori are the most predominant infection in developing countries, still there is a scarcity of data in Ethiopia. Moreover, the epidemiologic link between the H. pylori infection and metabolic changes is a topic of debate and controversial. Therefore, the current study aimed to investigate the burden of H-pylori infection and its association with dyslipidemia among asymptomatic adults in Jimma City, Ethiopia. Methods Study Setting and Period Community-based cross sectional study design was employed. The study was conducted in Jimma City, Oromia Regional State, and Southwest Ethiopia from July 17 to October 27, 2019. Sample Size and Sampling procedures The sample size was determined using the single population proportion formula considering 36.4% prevalence of H. pylori infection from the previous study ( 17 ), 95% confidence interval (CI), 3% margin of error, and 10% non-respondent rate. Finally the total sample size was, 1087 out of which only 865 participants were recruited to be included in the study. The sampling procedure from the district kebele to the study households and then selecting the study adults recruited according to the following procedure (Fig. 1 ). Figure 1 (Here) Data Collection Techniques and Data Collectors From each participant, data were collected by face-to-face interviews, by using pretested structured questionnaires that adopted from WHO STEPS survey instrument ( 18 ) adapted to the local context and which again languages based on the study objectives of the current study., Data were collected by six data collectors from JUMC paired with six health extension workers (HEWs) assigned to each kebeles of the study. Anthropometric Measurements Based on the standard measurement protocol, the height and weight was measured to the nearest 0.1cm and 0.1kg using an adjustable portable stadiometer (Model 871, Seca, Germany) and a digital weight scale respectively. Similarly, a waist circumference (WC) was measured to the nearest 0.1cm using a fixed tension tape meter without any pressure to the body surface. Blood Pressure (BP) Measurements In a sitting position, BP was measured from the right arm in triplicate using an Aneroid Sphygmomanometer with small, medium, and large handcuff size ( 19 ), as fit to the participants take rest for a minimum of five minutes. Then, two more consecutive measurements within five minutes apart were done. Dietary Diversity Score (DDS) and Survey Dietary diversity score was determined from data source of 24-h dietary recall of the study participants consumption of food groups within the past 24-h using the dietary individual or women dietary diversity guidelines ( 20 ). Data collectors were paired with local health extension workers and registered the information on food consumption using three consecutive 24-h dietary recalls (including two weekdays and one weekend day). Based on the guideline, all food items were categorized into 9 groups which were grains vegetables, fruits, meat, beans, eggs, fish, dairy, and oil. Screening Functional Gastrointestinal Disorders (FGIDs) Upper and lower abdominal pain symptoms of the FGIDs were screened by valid diagnostic criterion adopted from Rome III ( 1 ). Blood Biochemical Tests Venous blood sample (5ml) was drawn and centrifuged within 30–45 minutes of the draw.. Glucometer was used to measure blood glucose soon sample drowns. Blood serum was carried out in ABX Pentra 400 Automated Chemistry Machine (Horiba ABX SAS, 34184 Montpellier, France) at Jimma Medical Center (JMC) Clinical chemistry core laboratory for determine the lipid profile and serum glucose. But LD-c level was calculated by using the Freidwald formula ( 22 ). H. Pylori Stool Antigen Test Approximately, 20g of fresh stool was collected from each participant using clean, dry, leak-proof, and wide-mouthed containers. Based on the standard protocol and procedure, the stool specimen was tested by using one step stool antigen test (Zhejiang Orient Gene Biotech CO., LTD, China) with 94.9–100% sensitivity and 95–100% specificity ( 23 ). The test kit is validated and approved by the ministry of health and quality controlling agency and currently used as the gold standard for the diagnosis of H. pylori infection in Ethiopia. Operation Definition Behavioral factors (smokers, khat chewers and alcohol consumers): self-reported currently chewing of khat, smoking tobacco and consuming alcohol ( 24 ). Physical activity : Physical activities as per WHO recommended as all adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, per week ( 25 ). Sedentary behavior : Participants the time spent sitting during a typical week and classified as sedentary (if < 4 hours/day) and not sedentary (if ≥ 4 hours/day) per week ( 26 ). Body mass Index : BMI of the study participants was categorized as underweight ( 94cm and for women > 80cm were high and below considered as low ( 28 ). Blood pressure(BP) : Blood pressure of the participants were considered as pre-hypertensive as if systolic BP was 120–139 and diastolic BP 80–89mmHg, and hypertensive as if systolic BP ≥ 140mmHg and/or diastolic BP ≥ 90 mmHg ( 29 ). Lipid profiles : Operatioalized according to IDF of TC ≥ 200 mg/dl and < 200 mg/dl were considered as high and normal respectively. Likewise, LDL was considered as optimal when LDL < 100 mg/dl but elevated as LDL ≥ 100 mg/dl. Similarly, TAG level was considered as normal when TG 40 mg/dl for men and > 50 mg/dl for women, otherwise it was categorized as low ( 30 ). Dyslipidemia : an imbalance of any of lipids metabolism such as TC, LDL, TAG, and HDL ( 31 ). Functional Dyspepsia : Participants with upper abdominal pain symptoms of bothersome, postprandial fullness, early satiation, epigastric pain and burning symptoms for the last 3 months with symptom onset at least 6 months prior to functional dyspepsia diagnosis ( 21 ). Irritable Bowel Syndrome (IBS) : participants with symptoms of relief with defecation, onset associated with a change in frequency and appearance of stool symptoms and recurrent abdominal discomfort for at least 3 months in the previous 6 months, with 2 or more of the above symptoms ( 21 ). Co-occurrences of abdominal pains : Participants fulfill the criteria of both upper and lower abdominal pain symptoms according to Room-III criteria ( 21 ). Dietary Diversity Scores (DDS) : Consuming any food item from any of the nine categories would get one point in that food category and if not would be scored zero, but consuming different foods from the same category would assume not count repeatedly. Therefore, for this study purpose, the DDS was categorized into low (1–3 Categories), medium (4–5 categories), and high DDS (6–9 categories) ( 32 ). Data quality management One-day training was given to the six data collectors from JUMC and six HEWs on the contents of the questionnaires, how to approach and mobilize the study partcipants, sample collection procedures, biological sample handling and about ethical in regard of human research. Data were collected by local languages (Amharic and Afaan-Oromoo) after re-translated back to English and checked its consistency. All the sampling procedures, handling, processing and analysis were carried out by strictly following standard operational procedures (SOPs. All the reagents were checked for their expiry date and all the instruments were calibrated every day by running quality control samples before the actual sample test according to the manufacture’s recommendation. Data processing and analysis The data were entered into EPI data 3.1 and exported to SPSS 25 version for the analysis. Descriptive analysis was explored for the representation frequency, percentage and x 2 for categorical variables. By using binary logistic regression analysis, the independent variables associated with the H. pylori were determined with a P-value of < 0.2 in binary logistic regression were selected as candidates for further analysis with multiple logistic regressions. At last, variables with a P-value of < 0.05 at 95% CI were declared as statistically significant. Results Socio-demographic and wealth index characteristics In this study, a total of 865 healthy adults aged ≥ 18 were enrolled. Almost half, 415(48%), of the study participants were females. The mean age was 38.4 ± 13.5 years with 19 minimum and 88 maximum ages. The wealth index of the study participants were categorized as low 366(62.3%), middle 410(47.5%), and high 89(10.2%) ( Table 1 ). Behavioral and anthropometric characteristics Currently, smoker, alcohol drinker and khat chewer participants were 71(8.2%), 150(17.3%) and 315(36.4%), respectively. Of the study participants, 797(91.1%) and 660(71.3%) were using iodized salt and vegetable oil in meal preparation. Similarly, 646(70.4%) had a practice of drinking tea and/or coffee in hot frequently. Moreover, participants with less physical activity and sedentary life accounts, 308(45.6%) and 521(60.3%) respectively. The BMI value of the study participants categories accounts; 500(57.8%) normal, 238(27.5%) overweight and obese, and 127(14.7%) underweight. Similarly, 215(24.8%) of the participants had central obesity ( Table 1 ). Table 1(Here) H. pylori infection and dyslipidemia The H. pylori positive tests asymptomatically existing in the study participants was, 170(19.7%). The serum level of abnormal lipid profile among H. pylori positive individuals were 103(11.9%) HDL-c, 97(11.2%) LDL-c, 93(10.7%) TC, and 89(10.3%) TAG, whereas the prevalence of dyslipidemia among H. pylori positive tests was, 108(12.5%). The distribution of H. pylori positive was higher in hypercholesterolemia, hypertriglyceridemia, increased LDL-C, and decreased HDL-c as compared with their normal categories. This result indicates as H. pylori infection has a positive significantly associated with dyslipidemia ( Table 2 ). Table 2(here) H. Pylori infection and dietary diversity score (DDS) The DDS distribution of the study participants were, 426(49.2%) middle DDS, 331(38.3%) higher DDS and 108(12.5%) low DDS (Table.1). The prevalence of H. py lori positive was distributed as 82(9.5%) in middle, 64(7.4%) in higher and 24(2.8%) in low DDS groups of the study participants. However, pattern of H. pylori infection (positive) and non-infection (negative test) in the three DDS groups nearly the same ( Figure.2 ). Figure 2 (Here) Factors associated with H. pylori positive stool antigen test As showed in Table 3, with potential confounders adjusted, the factors associated with H. pylori positive tests with an AOR (95% CI) were chewing khat: 1.83(1.06–3.13), in hot drink of tea and/or coffee trend: 3.85(1.70–8.71), using butter or ghee and margarine:2.63(1.16–5.96), less physical activity: 1.36(0.85–2.16), hypertriglyceridemia: 2.50(1.59–3.92), increased LDL-c: 2.50(1.59–3.92), decreased HDL-c: 1.50(0.96–2.32), hypercholesterolemia: 4.33(2.33–8.06), being hypertensive:1.34(0.832–2.17) and central obesity: 3.86(2.00–7.48), dyslipidemia: 5.11(4.27–8.46) and functional dyspepsia: 7.23 (5.23–11.01) as compared to their normal counterparts ( Table. 3 ) Table 3(here) Discussion Helicobacter pylori Infection is very prevalent around the world and the infection estimated about 48.6% of the global adult population ( 33 ). Moreover, in developing countries, H. pylori infection affects more than 80% of the general populations ( 34 ). Similarly, evidence in Ethiopia revealed as more than half of population were infected ( 35 ). In the current study, using rapid stool antigen test for the diagnosis, the H. pylori positive test was found to be 19.7%, as this shows that there is H. pylori infection burden exists in asymptomatic in the study group. This finding is less than the findings in United Arab Emirates, 41% ( 36 ), Ethiopia, 71–91%( 4), and Iran. 66.5% ( 37 ). But it is higher than finding in Yirga Cheffe Primary Hospital, Southern Ethiopia, 7.7%( 3). This inconsistency might be due to differences in socio demographic and economic status, dietary habits, means of diagnosing modalities, health status, hygienic condition and living environment of the study participants involved. Although the magnitude of H. pylori in the study area is relatively low, it was expected to be less than the observed prevalence due to the study participants are apparently health. Although there is lack of evidence on apparently healthy community in the study area, many findings demonstrated that H. pylori infection affected the cardiovascular system leading to the alteration of TC, TAG, LDL-c, and HDL-c ( 38 , 39 ). As showed in Tables 2 and 3 , the distribution of H. pylori infection was higher in hypercholesterolemia and hypertriglyceridemia, by the odds of 4.33 and 2.50 respectively, as compared with their normal categories. Moreover, H. pylori infection was highly prevalent in increased LDL-c by the odds of 2.50, decreased HDL-c by the odds of 1.50 and dyslipidemia by the odds of 5.11 as compared with their normal categories. These findings are similar with the findings in China ( 37 ), Japan ( 38 ) and Ethiopia ( 40 ). In the recent study, the occurrence of H. pylori infection (positive) was distributed as 82(9.5%) in middle, 64(7.4%) in higher, and 24(2.8%) in low DDS groups of the study participants. Although H. pylori infection varied with in those varied DDS groups, it is indicating as there is no statically significant association with any of the varied DDS groups. As showed in Fig. 2 in the current study, the pattern of H. pylori infection (positive) and non-infection (negative) results revealing in the varied DDS groups nearly the same. This might be due to DDS in the current study considered is not telling the nutritional contents. But, another finding concluded that a highly and frequently intake of plant products (green tea, fruits and vegetables) are useful remedies for protecting the infections ( 41 ). Contrary to this, high intake of red meat and/or processed meat, preserved foods often high in salt increased the risk the infections ( 42 ). In general, as showed in Table 3 , chewing khat, in hot drink of tea and/or coffee trend, using butter and margarine in meal preparation, less physical activity, hypertriglyceridemia, increased LDL-c, decreased HDL-c, hypercholesterolemia, dyslipidemia, being hypertensive, central obese, and abdominal pain symptoms were independently increase the odds of H. pylori infections. In the current study, the odd of H. pylori infection was nearly two times 1.83 more likely higher in khat chewers as compared with non-chewers. This finding is agreed with findings in Kenya and Ethiopia ( 43 , 44 ), but contrary with other finding in Ethiopia ( 45 ). In the recent study and contrary to khat, alcohol conception is not associated with H. pylori infection. This is in line with finding in Germany ( 46 ), but it is contrary with other finding in Ethiopia ( 47 ). Likewise, the odds of H. pylori infection nearly 3 times more likely prevalent in hot drink of tea and/or coffee trend as compared with individuals not drink in hot. This finding agreed with findings in Ethiopia ( 44 ). Also, the odd of H. pylori infection was 2.5 times more likely higher in butter or ghee and margarine users as compared with vegetable oil users in meal preparation. Perhaps the content of butter or ghee and margarine might aggravate H. pylori infection as contrary vegetable oil might have the counter effects. Moreover, in the current study, the odds of H. pylori infection was nearly 1.5 times more likely higher in not at all or less physical activity as compared with physical activity performing participants as per WHO recommendations. This finding agreed with finding done on Korean population ( 48 ). Similarly, the odd of H. pylori infection was nearly 4 times more likely higher in central obese as compared with non-obese participants. This finding agreed with finding in China ( 49 ), but contrary with other finding in China ( 50 ). Also, the odd of H. pylori infection was nearly 1.5 times more likely associated with hypertensive as compared with non-hypertensive participants. This finding is in line with the findings in Ethiopia ( 51 ) and in China ( 52 , 53 , 54 ). Furthermore, the odd of H. pylori infection was 7 times more likely associated with upper abdominal pain (functional dyspepsia) as compared with non-dyspeptic participants. This finding again agrees with other findings in Ethiopia ( 55 , 56 ). As summary, the current study is useful to understand the asymptomatically prevailing of H. pylori infection in the community, and it had a strong association with dyslipidemia. Moreover, other risks factors associated with the infection in the study community are identified. In addition, these findings are useful as a benchmark for researchers to look at the cause and effect of the association and health professionals to early diagnose, reverse its impacts and the aggravating risk factors. Despite this study has many strengths, it also has some limitations. Since the study was a single-centered cross-sectional result, it is not used to infer national. Moreover, it is also important to mention its lack of including all age groups and telling the cause-and-effect relationship of the variables with health-related outcomes and economics. Conclusion H. pylori infection is highly prevalent in the community. Moreover, H. pylori infection is significantly associated with the incidence of dyslipidemia. Similarly, in hot drink trend of tea and/or coffee, chewing khat, less physical activities, being hypertensive, central obese, dyspepsia. Therefore, early screening and decreasing those risk factors is promising and continuously emerging option to reduce the double burden H- pylori infection and dyslipidemia. Abbreviations AOR : Adjusted Odds Ratio BMI : Body Mass Index BP : Blood Pressure CI : Confidence Interval COR : Crude Odds Ratio DDS : Dietary Diversity Score DM : Diabetes Mellitus FBS : Fasting Blood Sugar FD : Functional Dyspepsia FGIDS : Functional Gastrointestinal Disorders H. pylori : Helicobacter pylori HDL-c : High Density Lipoprotein cholesterol HEWs : Health Extension Workers IHRPGD : Institute of Health Research Post Graduate Development IRB : Institutional Review Board JUMC : Jimma University Medical Center LDL-c : Low-Density Lipoprotein cholesterol RBS: Random Blood Sugar STEPS : STEP wise approach to NCD risk factor surveillance. T 2 DM : Type 2 Diabetes Mellitus TAG/TG : Triacylglycerol/Triglyceride TC : Total Cholesterol; VITRAS : Virtual Institute for Transdisciplinary Research and Scholarship Africa WC : Waist Circumference WHO : World Health Organization Declarations Ethics Approval and Consent to Participate All procedures performed in studies involving human participants were in accordance with the ethical standards of the Jimma Institutional Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted with approval from the Institutional Review Board (IRB), Institute of Health, Jimma University (Ref. No: IHRPGD595/2019). All the participants were provided oral and written informed consent. Consent for Publication Not applicable. Availability Data and Materials The datasets generated during and/or analysed during this study are available from the corresponding author on reasonable request. Competing Interests The authors declare no competing of interest. Funding This research project supported by Postgraduate and Research Directorate of the Institute of Health, Jimma University and as seed money by Virtual Institute for Transdisciplinary Research and Scholarship Africa (VITRAS) of Texas Tech University in collaboration with Jimma University. Authors’ contribution BZ and TB participated on study conceptualization and study design. BZ, TB, KHA and DT, involved on supervision, data acquisition, analysis, and interpretation. BZ and MT performed laboratory works and interpretation. BZ, AE and ST took part in manuscript preparation and edition. Lastly, all authors gave final read and approval of the version to be published; and agree to be accountable for all aspects of the contents of the article. Acknowledgments The authors thank the supporter of this project and study participants. Authors Information 1 Department of Biomedical Sciences, Jimma University, Jimma City, Ethiopia 2 Department of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia 1 Department of Biomedical Sciences, Jimma University, Jimma City, Ethiopia 3 Department of Biomedical Sciences, Injibara University, Injibara Town, Ethiopia 4 Department Medical Laboratory, Jimma University, Jimma City, Ethiopia 2 Department of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia 2 Department of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia References Testerman, T.L. and Morris, J. (2014) Beyond the Stomach: An Updated View of Helicobacter pylori Pathogenesis, Diagnosis, and Treatment. World Journal of Gastroenterology, 20, 12781-12808. http://dx.doi.org/10.3748/wjg.v20.i36.12781 J.C. Atherton. Thepathogenesis of Helicobacter pylori-induced gastro-duodenal diseases Annu. Rev. Pathol., 1 (2006), pp. 63-96 Ayele B, Molla E. 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Ahmedmenewer Abdu, Waqtola Cheneke, Mohammed Adem, Rebuma Belete & Aklilu Getachew. Dyslipidemia and Associated Factors Among Patients Suspected to Have Helicobacter pylori Infection at Jimma University Medical Center, Jimma, Ethiopia, International Journal of General Medicine . 202013:, 311-321, DOI: 10.2147/IJGM.S243848 N. Lunet, A. Lacerda-Vieira, and H. Barros, “Fruit and vegetables consumption and gastric cancer: a systematic review and meta-analysis of cohort studies,” Nutrition and Cancer, vol. 53, no. 1, pp. 1–10, 2005. C. A. Gonzalez and E. Riboli. Diet and cancer prevention: where we are, where we are going. Nutrition and Cancer. 2006, vol. 56, no. 2, pp. 225–231. M. A. Hassan, K. Mohamed, N. Zipporah and L. Hudson. Association between khat (catha edulis) chewing and infection with helicobacter pylori. East African Medical Journal. March 2015; Vol. 92; No. 3. Negash M, Wondifraw Baynes H, Geremew D. Helicobacter pylori Infection and Its Risk Factors: A Prospective Cross-Sectional Study in Resource-Limited Settings of Northwest Ethiopia. Can J Infect Dis Med Microbiol. 2018 Oct 18;2018:9463710. doi: 10.1155/2018/9463710. PMID: 30420905; PMCID: PMC6211158. Kitila KT, Sori LM, Desalegn DM, Tullu KD. Burden of Helicobacter pylori Infections and Associated Risk Factors among Women of Child Bearing Age in Addis Ababa, Ethiopia. Int J Chronic Dis. 2018 Nov 12;2018:5183713. doi: 10.1155/2018/5183713. PMID: 30538998; PMCID: PMC6260533. Brenner H, Berg G, Lappus N, Kliebsch U, Bode G, Boeing H. Alcohol consumption and Helicobacter pylori infection: results from the German National Health and Nutrition Survey. Epidemiology. 1999 May;10(3):214-8. PMID: 10230827. Melese, A., Genet, C., Zeleke, B. et al. Helicobacter pylori infections in Ethiopia; prevalence and associated factors: a systematic review and meta-analysis. BMC Gastroenterol 19, 8 (2019). https://doi.org/10.1186/s12876-018-0927-3 Gunathilake MN, Lee J, Jang A, Choi IJ, Kim Y-I, Kim J. Physical Activity and Gastric Cancer Risk in Patients with and without Helicobacter pylori Infection in A Korean Population: A Hospital-Based Case-Control Study. Cancers. 2018; 10(10):369. https://doi.org/10.3390/cancers10100369 Qinqin Wu. & Ken Qin. & Youjuan Wang . Central obesity is associated with helicobacter pylori infection: a large-scale cross-sectional retrospective study in West China. International Journal of Diabetes in Developing Countries. 2020) 40(1): 2–60. https://doi.org/10.1007/s13410-019-00765-8 Xu MY, Liu L, Yuan BS, Yin J, Lu QB. Association of obesity with Helicobacter pylori infection: A retrospective study. World J Gastroenterol. 2017 Apr 21;23(15):2750-2756. doi: 10.3748/wjg.v23.i15.2750. PMID: 28487612; PMCID: PMC5403754. Tsegaye N, Diriba R, Araya S. Magnitude of H. pylori and Its Association with Preeclampsia Among Pregnant Women in Ethiopia: A Case Control Study. Int J Womens Health. 2022 May 2;14:635-642. doi: 10.2147/IJWH.S363137. PMID: 35535149; PMCID: PMC9077130. Wan, Z., Hu, L., Hu, M. et al. Helicobacter pylori infection and prevalence of high blood pressure among Chinese adults. J Hum Hypertens 32, 158–164 (2018). https://doi.org/10.1038/s41371-017-0028-8 Yue L, Zhang R, Chen S, Duan G. Relationship between Helicobacter pylori and Incident Hypertension as well as Blood Pressure: A Systematic Review and Meta-Analysis. Dig Dis. 2023;41(1):124-137. doi: 10.1159/000524078. Epub 2022 Apr 4. PMID: 35378540. Fang Y, Xie H, Fan C. Association of hypertension with helicobacter pylori: A systematic review and meta‑analysis. PLoS One. 2022 May 19;17(5):e0268686. doi: 10.1371/journal.pone.0268686. Erratum in: PLoS One. 2022 Oct 24;17(10):e0276919. PMID: 35588432; PMCID: PMC9119435. Taddesse G, Habteselassie A, Desta K, Esayas S, Bane A. Association of dyspepsia symptoms and Helicobacter pylori infections in private higher clinic, Addis Ababa, Ethiopia. Ethiop Med J. 2011 Apr;49(2):109-16. PMID: 21796910. Belay Zawdie, KalkidanHassen Abate, Dessalegn Tamiru, TeferaBelachew. Abdominal Pain of FunctionalGastrointestinal Disorders in DietaryDiversity Patterns and Its Determinantsamong Healthy Adults in Jimma City,Southwest Ethiopia. Ethiop J Health Sci.2023;33(6):1027. doi: http://dx.doi.org/10.4314/ejhs. v33i6.13 Tables Tables are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files TablesofH.PpyloriBMCN.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5237619","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":375579313,"identity":"aa40fdfa-e861-4286-8ebc-fb45f61acc5b","order_by":0,"name":"Belay Zawdie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIie3RsWoCMRzH8YRAXSKuAcW+grfUCn2TLh4FJ7NnsPJ3OZd7gBaKfYV2cU4IXJeAq+DQ+gaON/q7jsJ5diuY73BDyAf+/xxjsdg/bMDEwjJ232OtBdmxwZEQ1EA4gSjJpHc/h1ARfilRk6fkNavOGsgQ87jSKNmh6V23vXp+7CxBSrOuJaPckVVBSWUDyPpLv3hOPA+7+sG2Kdkkw2Aur0ihCUTw7Az53pNNQW69BHkr9Hsj2WJ9BzIobrA+zfRHExnlKTnCLkkQeOTC6k8Qd26XYcu7fWke+v1qwvFsrlcb/KDS1JPT/O/XXnwfzf9yORaLxa6kI9EGZBZBu4Z2AAAAAElFTkSuQmCC","orcid":"","institution":"Jimma University","correspondingAuthor":true,"prefix":"","firstName":"Belay","middleName":"","lastName":"Zawdie","suffix":""},{"id":375579314,"identity":"3f5a8673-5ff8-4fca-98a8-1e9c61cb77af","order_by":1,"name":"Kalkidan Hassen Abate","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Kalkidan","middleName":"Hassen","lastName":"Abate","suffix":""},{"id":375579317,"identity":"26d67b54-bc6c-4125-aac4-fae4981b1e4f","order_by":2,"name":"Solomon Tesfaye","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Solomon","middleName":"","lastName":"Tesfaye","suffix":""},{"id":375579318,"identity":"b9942f27-ec52-4d47-8fe2-a6174fb2171a","order_by":3,"name":"Aklesya Enkobahry","email":"","orcid":"","institution":"Injibara University","correspondingAuthor":false,"prefix":"","firstName":"Aklesya","middleName":"","lastName":"Enkobahry","suffix":""},{"id":375579319,"identity":"7cf30341-0fab-48d7-b93b-e4ef110d0c12","order_by":4,"name":"Mulualem Tadesse","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Mulualem","middleName":"","lastName":"Tadesse","suffix":""},{"id":375579320,"identity":"11e226fa-9d0a-4bb0-b2b4-f5f161ec76fd","order_by":5,"name":"Dessalegn Tamiru","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Dessalegn","middleName":"","lastName":"Tamiru","suffix":""},{"id":375579321,"identity":"f502a50f-5b7f-4a53-abeb-4c5122a4ea72","order_by":6,"name":"Tefera Belachew","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"prefix":"","firstName":"Tefera","middleName":"","lastName":"Belachew","suffix":""}],"badges":[],"createdAt":"2024-10-10 08:08:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5237619/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5237619/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69886292,"identity":"fd194ea3-6e84-4ec0-b9be-a00abba9c859","added_by":"auto","created_at":"2024-11-26 09:49:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":226238,"visible":true,"origin":"","legend":"\u003cp\u003eSampling procedures and response rate of study participants in Jimma city, Southwest Ethiopia, 2019 (n=865)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5237619/v1/fdcbf6cf3965d60c34ce6d7b.png"},{"id":69886293,"identity":"9901c926-a14a-456e-9545-130c3991376c","added_by":"auto","created_at":"2024-11-26 09:49:44","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":221603,"visible":true,"origin":"","legend":"\u003cp\u003eMagnitude of H-\u003cem\u003ePylori \u003c/em\u003einfection among different Dietary Diversity Score (DDS) group \u0026nbsp;\u0026nbsp;among asymptomatic adults in Jimma City,Southwest Ethiopia, 2019(n=865)\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5237619/v1/a58750ae7b5b2ce93f6e4958.png"},{"id":72468379,"identity":"a1097d24-fe26-4ff6-91b7-9a2522b9a67e","added_by":"auto","created_at":"2024-12-27 13:23:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1109577,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5237619/v1/d7886946-cf35-4b1f-9541-752f4c511bf4.pdf"},{"id":69886295,"identity":"7dacdf41-5e7c-42a3-8332-c3b733ff3b4b","added_by":"auto","created_at":"2024-11-26 09:49:44","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":223970,"visible":true,"origin":"","legend":"","description":"","filename":"TablesofH.PpyloriBMCN.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5237619/v1/d78153fc8dd94a8e0a2f312c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Relationship between helicobacter pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHelicobacter pylorus (H. pylorus) is gram-negative pathogenic bacterium that causes acute and chronic gastro-duodenal diseases (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). H. \u003cem\u003epylori\u003c/em\u003e infection affects more than 80% of the populations in developing countries (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Similarly, the prevalence of \u003cem\u003eH. pylori\u003c/em\u003e infection in Ethiopia oscillated from 7.7\u0026ndash;91% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Moreover, in developing countries, H. \u003cem\u003epylori\u003c/em\u003e infections and its associated diseases are usually occurring at earlier ages (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). On the other hand, dyslipidemia which is highly associated with advanced age brings implications inside the cardiovascular system leads to vascular coronary disease and atherosclerosis; and its co-occurrence with \u003cem\u003eH. pylori\u003c/em\u003e infection shows the possible alteration of the serum lipid profile (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEvidence showed as H. \u003cem\u003epylori\u003c/em\u003e infection along dyslipidemia, impaired glucose metabolism and endothelial dysfunction; contributed in pathogenesis of atherosclerosis (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Likewise, there is a positive relation between cytotoxic associated gene-A (Cag A) positive strain of H. pylori and vascular diseases (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFurthermore, there are evidences potentially suggesting the possible association between \u003cem\u003eH. pylori\u003c/em\u003e infection and vitamin B12 deficiency that has been leading to extra gastric clinical signs accelerates alteration of total cholesterol, triglycerides, LDL-c, and HDL-c (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Ethiopia, studies indicated that more than half of Ethiopians were chronically infected with \u003cem\u003eH. pylori\u003c/em\u003e (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and its impacts on metabolic syndrome and serum lipid profile alteration (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Despite the fact that \u003cem\u003eH. pylori\u003c/em\u003e are the most predominant infection in developing countries, still there is a scarcity of data in Ethiopia. Moreover, the epidemiologic link between the H. \u003cem\u003epylori\u003c/em\u003e infection and metabolic changes is a topic of debate and controversial. Therefore, the current study aimed to investigate the burden of \u003cem\u003eH-pylori\u003c/em\u003e infection and its association with dyslipidemia among asymptomatic adults in Jimma City, Ethiopia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Setting and Period\u003c/h2\u003e \u003cp\u003eCommunity-based cross sectional study design was employed. The study was conducted in Jimma City, Oromia Regional State, and Southwest Ethiopia from July 17 to October 27, 2019.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample Size and Sampling procedures\u003c/h3\u003e\n\u003cp\u003eThe sample size was determined using the single population proportion formula considering 36.4% prevalence of H. \u003cem\u003epylori\u003c/em\u003e infection from the previous study (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), 95% confidence interval (CI), 3% margin of error, and 10% non-respondent rate. Finally the total sample size was, 1087 out of which only \u003cb\u003e865\u003c/b\u003e participants were recruited to be included in the study.\u003c/p\u003e \u003cp\u003eThe sampling procedure from the district kebele to the study households and then selecting the study adults recruited according to the following procedure (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e(Here)\u003c/b\u003e\u003c/p\u003e\n\u003ch3\u003eData Collection Techniques and Data Collectors\u003c/h3\u003e\n\u003cp\u003eFrom each participant, data were collected by face-to-face interviews, by using pretested structured questionnaires that adopted from WHO STEPS survey instrument (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) adapted to the local context and which again languages based on the study objectives of the current study., Data were collected by six data collectors from JUMC paired with six health extension workers (HEWs) assigned to each kebeles of the study.\u003c/p\u003e\n\u003ch3\u003eAnthropometric Measurements\u003c/h3\u003e\n\u003cp\u003eBased on the standard measurement protocol, the height and weight was measured to the nearest 0.1cm and 0.1kg using an adjustable portable stadiometer (Model 871, Seca, Germany) and a digital weight scale respectively. Similarly, a waist circumference (WC) was measured to the nearest 0.1cm using a fixed tension tape meter without any pressure to the body surface.\u003c/p\u003e\n\u003ch3\u003eBlood Pressure (BP) Measurements\u003c/h3\u003e\n\u003cp\u003eIn a sitting position, BP was measured from the right arm in triplicate using an Aneroid Sphygmomanometer with small, medium, and large handcuff size (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), as fit to the participants take rest for a minimum of five minutes. Then, two more consecutive measurements within five minutes apart were done.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDietary Diversity Score (DDS) and Survey\u003c/h2\u003e \u003cp\u003eDietary diversity score was determined from data source of 24-h dietary recall of the study participants consumption of food groups within the past 24-h using the dietary individual or women dietary diversity guidelines (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Data collectors were paired with local health extension workers and registered the information on food consumption using three consecutive 24-h dietary recalls (including two weekdays and one weekend day). Based on the guideline, all food items were categorized into 9 groups which were grains vegetables, fruits, meat, beans, eggs, fish, dairy, and oil.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eScreening Functional Gastrointestinal Disorders (FGIDs)\u003c/h3\u003e\n\u003cp\u003eUpper and lower abdominal pain symptoms of the FGIDs were screened by valid diagnostic criterion adopted from Rome III (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eBlood Biochemical Tests\u003c/h3\u003e\n\u003cp\u003eVenous blood sample (5ml) was drawn and centrifuged within 30\u0026ndash;45 minutes of the draw.. Glucometer was used to measure blood glucose soon sample drowns. Blood serum was carried out in ABX Pentra 400 Automated Chemistry Machine (Horiba ABX SAS, 34184 Montpellier, France) at Jimma Medical Center (JMC) Clinical chemistry core laboratory for determine the lipid profile and serum glucose. But LD-c level was calculated by using the Freidwald formula (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eH.\u003c/b\u003e \u003cb\u003ePylori\u003c/b\u003e \u003cb\u003eStool Antigen Test\u003c/b\u003e\u003c/p\u003e \u003cp\u003eApproximately, 20g of fresh stool was collected from each participant using clean, dry, leak-proof, and wide-mouthed containers. Based on the standard protocol and procedure, the stool specimen was tested by using one step stool antigen test (Zhejiang Orient Gene Biotech CO., LTD, China) with 94.9\u0026ndash;100% sensitivity and 95\u0026ndash;100% specificity (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The test kit is validated and approved by the ministry of health and quality controlling agency and currently used as the gold standard for the diagnosis of H. \u003cem\u003epylori\u003c/em\u003e infection in Ethiopia.\u003c/p\u003e \u003cp\u003e \u003cb\u003eOperation Definition\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eBehavioral factors\u003c/b\u003e (smokers, khat chewers and alcohol consumers): self-reported currently chewing of khat, smoking tobacco and consuming alcohol (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePhysical activity\u003c/b\u003e: Physical activities as per WHO recommended as all adults should undertake 150\u0026ndash;300 min of moderate-intensity, or 75\u0026ndash;150 min of vigorous-intensity physical activity, per week (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eSedentary behavior\u003c/b\u003e: Participants the time spent sitting during a typical week and classified as sedentary (if\u0026thinsp;\u0026lt;\u0026thinsp;4 hours/day) and not sedentary (if\u0026thinsp;\u0026ge;\u0026thinsp;4 hours/day) per week (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eBody mass Index\u003c/b\u003e: BMI of the study participants was categorized as underweight (\u0026lt;\u0026thinsp;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e), normal [18.5\u0026ndash;24.9 kg/m\u003csup\u003e2\u003c/sup\u003e], overweight [25\u0026ndash;29.9 kg/m\u003csup\u003e2\u003c/sup\u003e] and obese (\u0026ge;\u0026thinsp;30 kg/m\u003csup\u003e2\u003c/sup\u003e) ( 27).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eWaist Circumference\u003c/b\u003e (WC): Waist circumference for men values\u0026thinsp;\u0026gt;\u0026thinsp;94cm and for women\u0026thinsp;\u0026gt;\u0026thinsp;80cm were high and below considered as low (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eBlood pressure(BP)\u003c/b\u003e: Blood pressure of the participants were considered as pre-hypertensive as if systolic BP was 120\u0026ndash;139 and diastolic BP 80\u0026ndash;89mmHg, and hypertensive as if systolic BP\u0026thinsp;\u0026ge;\u0026thinsp;140mmHg and/or diastolic BP\u0026thinsp;\u0026ge;\u0026thinsp;90 mmHg (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eLipid profiles\u003c/b\u003e: Operatioalized according to IDF of TC\u0026thinsp;\u0026ge;\u0026thinsp;200 mg/dl and \u0026lt;\u0026thinsp;200 mg/dl were considered as high and normal respectively. Likewise, LDL was considered as optimal when LDL\u0026thinsp;\u0026lt;\u0026thinsp;100 mg/dl but elevated as LDL\u0026thinsp;\u0026ge;\u0026thinsp;100 mg/dl. Similarly, TAG level was considered as normal when TG\u0026thinsp;\u0026lt;\u0026thinsp;150 mg/dl and HDL was considered as desirable/normal if it is \u0026gt;\u0026thinsp;40 mg/dl for men and \u0026gt;\u0026thinsp;50 mg/dl for women, otherwise it was categorized as low (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eDyslipidemia\u003c/b\u003e: an imbalance of any of lipids metabolism such as TC, LDL, TAG, and HDL (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eFunctional Dyspepsia\u003c/b\u003e: Participants with upper abdominal pain symptoms of bothersome, postprandial fullness, early satiation, epigastric pain and burning symptoms for the last 3 months with symptom onset at least 6 months prior to functional dyspepsia diagnosis (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eIrritable Bowel Syndrome (IBS)\u003c/b\u003e: participants with symptoms of relief with defecation, onset associated with a change in frequency and appearance of stool symptoms and recurrent abdominal discomfort for at least 3 months in the previous 6 months, with 2 or more of the above symptoms (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCo-occurrences of abdominal pains\u003c/b\u003e: Participants fulfill the criteria of both upper and lower abdominal pain symptoms according to Room-III criteria (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eDietary Diversity Scores (DDS)\u003c/b\u003e: Consuming any food item from any of the nine categories would get one point in that food category and if not would be scored zero, but consuming different foods from the same category would assume not count repeatedly. Therefore, for this study purpose, the DDS was categorized into low (1\u0026ndash;3 Categories), medium (4\u0026ndash;5 categories), and high DDS (6\u0026ndash;9 categories) (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData quality management\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eOne-day training was given to the six data collectors from JUMC and six HEWs on the contents of the questionnaires, how to approach and mobilize the study partcipants, sample collection procedures, biological sample handling and about ethical in regard of human research. Data were collected by local languages (Amharic and Afaan-Oromoo) after re-translated back to English and checked its consistency. All the sampling procedures, handling, processing and analysis were carried out by strictly following standard operational procedures (SOPs. All the reagents were checked for their expiry date and all the instruments were calibrated every day by running quality control samples before the actual sample test according to the manufacture\u0026rsquo;s recommendation.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eThe data were entered into EPI data 3.1 and exported to SPSS 25 version for the analysis. Descriptive analysis was explored for the representation frequency, percentage and x\u003csup\u003e2\u003c/sup\u003e for categorical variables. By using binary logistic regression analysis, the independent variables associated with the H. \u003cem\u003epylori\u003c/em\u003e were determined with a P-value of \u0026lt;\u0026thinsp;0.2 in binary logistic regression were selected as candidates for further analysis with multiple logistic regressions. At last, variables with a P-value of \u0026lt;\u0026thinsp;0.05 at 95% CI were declared as statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic and wealth index characteristics\u003c/h2\u003e \u003cp\u003eIn this study, a total of 865 healthy adults aged\u0026thinsp;\u0026ge;\u0026thinsp;18 were enrolled. Almost half, 415(48%), of the study participants were females. The mean age was 38.4\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5 years with 19 minimum and 88 maximum ages. The wealth index of the study participants were categorized as low 366(62.3%), middle 410(47.5%), and high 89(10.2%) (\u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eBehavioral and anthropometric characteristics\u003c/h2\u003e \u003cp\u003eCurrently, smoker, alcohol drinker and khat chewer participants were 71(8.2%), 150(17.3%) and 315(36.4%), respectively. Of the study participants, 797(91.1%) and 660(71.3%) were using iodized salt and vegetable oil in meal preparation. Similarly, 646(70.4%) had a practice of drinking tea and/or coffee in hot frequently. Moreover, participants with less physical activity and sedentary life accounts, 308(45.6%) and 521(60.3%) respectively. The BMI value of the study participants categories accounts; 500(57.8%) normal, 238(27.5%) overweight and obese, and 127(14.7%) underweight. Similarly, 215(24.8%) of the participants had central obesity (\u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;1(Here)\u003c/b\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eH. pylori infection and dyslipidemia\u003c/h2\u003e \u003cp\u003eThe H. \u003cem\u003epylori\u003c/em\u003e positive tests asymptomatically existing in the study participants was, 170(19.7%). The serum level of abnormal lipid profile among H. \u003cem\u003epylori\u003c/em\u003e positive individuals were 103(11.9%) HDL-c, 97(11.2%) LDL-c, 93(10.7%) TC, and 89(10.3%) TAG, whereas the prevalence of dyslipidemia among H. pylori positive tests was, 108(12.5%). The distribution of H. \u003cem\u003epylori\u003c/em\u003e positive was higher in hypercholesterolemia, hypertriglyceridemia, increased LDL-C, and decreased HDL-c as compared with their normal categories. This result indicates as H. \u003cem\u003epylori\u003c/em\u003e infection has a positive significantly associated with dyslipidemia (\u003cb\u003eTable\u0026nbsp;2\u003c/b\u003e).\u003c/p\u003e \u003cp\u003e \u003cem\u003eTable\u0026nbsp;2(here)\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eH.\u003c/b\u003e \u003cb\u003ePylori\u003c/b\u003e \u003cb\u003einfection and dietary diversity score (DDS)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe DDS distribution of the study participants were, 426(49.2%) middle DDS, 331(38.3%) higher DDS and 108(12.5%) low DDS (Table.1). The prevalence of H. py\u003cem\u003elori\u003c/em\u003e positive was distributed as 82(9.5%) in middle, 64(7.4%) in higher and 24(2.8%) in low DDS groups of the study participants. However, pattern of H. \u003cem\u003epylori\u003c/em\u003e infection (positive) and non-infection (negative test) in the three DDS groups nearly the same (\u003cb\u003eFigure.2\u003c/b\u003e).\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cem\u003e(Here)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eFactors associated with H.\u003c/b\u003e \u003cb\u003epylori\u003c/b\u003e \u003cb\u003epositive stool antigen test\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAs showed in Table\u0026nbsp;3, with potential confounders adjusted, the factors associated with H. \u003cem\u003epylori\u003c/em\u003e positive tests with an AOR (95% CI) were chewing khat: 1.83(1.06\u0026ndash;3.13), in hot drink of tea and/or coffee trend: 3.85(1.70\u0026ndash;8.71), using butter or ghee and margarine:2.63(1.16\u0026ndash;5.96), less physical activity: 1.36(0.85\u0026ndash;2.16), hypertriglyceridemia: 2.50(1.59\u0026ndash;3.92), increased LDL-c: 2.50(1.59\u0026ndash;3.92), decreased HDL-c: 1.50(0.96\u0026ndash;2.32), hypercholesterolemia: 4.33(2.33\u0026ndash;8.06), being hypertensive:1.34(0.832\u0026ndash;2.17) and central obesity: 3.86(2.00\u0026ndash;7.48), dyslipidemia: 5.11(4.27\u0026ndash;8.46) and functional dyspepsia: 7.23 (5.23\u0026ndash;11.01) as compared to their normal counterparts (\u003cb\u003eTable. 3\u003c/b\u003e)\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;3(here)\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eHelicobacter \u003cem\u003epylori\u003c/em\u003e Infection is very prevalent around the world and the infection estimated about 48.6% of the global adult population (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Moreover, in developing countries, H. \u003cem\u003epylori\u003c/em\u003e infection affects more than 80% of the general populations (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Similarly, evidence in Ethiopia revealed as more than half of population were infected (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). In the current study, using rapid stool antigen test for the diagnosis, the H. \u003cem\u003epylori\u003c/em\u003e positive test was found to be 19.7%, as this shows that there is H. \u003cem\u003epylori\u003c/em\u003e infection burden exists in asymptomatic in the study group. This finding is less than the findings in United Arab Emirates, 41% (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e), Ethiopia, 71\u0026ndash;91%( 4), and Iran. 66.5% (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). But it is higher than finding in Yirga Cheffe Primary Hospital, Southern Ethiopia, 7.7%( 3). This inconsistency might be due to differences in socio demographic and economic status, dietary habits, means of diagnosing modalities, health status, hygienic condition and living environment of the study participants involved. Although the magnitude of H. \u003cem\u003epylori\u003c/em\u003e in the study area is relatively low, it was expected to be less than the observed prevalence due to the study participants are apparently health.\u003c/p\u003e \u003cp\u003eAlthough there is lack of evidence on apparently healthy community in the study area, many findings demonstrated that H. \u003cem\u003epylori\u003c/em\u003e infection affected the cardiovascular system leading to the alteration of TC, TAG, LDL-c, and HDL-c (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). As showed in \u003cem\u003eTables\u0026nbsp;2 and 3\u003c/em\u003e, the distribution of H. \u003cem\u003epylori\u003c/em\u003e infection was higher in hypercholesterolemia and hypertriglyceridemia, by the odds of 4.33 and 2.50 respectively, as compared with their normal categories. Moreover, H. \u003cem\u003epylori\u003c/em\u003e infection was highly prevalent in increased LDL-c by the odds of 2.50, decreased HDL-c by the odds of 1.50 and dyslipidemia by the odds of 5.11 as compared with their normal categories. These findings are similar with the findings in China (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), Japan (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e) and Ethiopia (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the recent study, the occurrence of H. \u003cem\u003epylori\u003c/em\u003e infection (positive) was distributed as 82(9.5%) in middle, 64(7.4%) in higher, and 24(2.8%) in low DDS groups of the study participants. Although H. \u003cem\u003epylori\u003c/em\u003e infection varied with in those varied DDS groups, it is indicating as there is no statically significant association with any of the varied DDS groups. As showed in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e in the current study, the pattern of H. \u003cem\u003epylori\u003c/em\u003e infection (positive) and non-infection (negative) results revealing in the varied DDS groups nearly the same. This might be due to DDS in the current study considered is not telling the nutritional contents. But, another finding concluded that a highly and frequently intake of plant products (green tea, fruits and vegetables) are useful remedies for protecting the infections (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Contrary to this, high intake of red meat and/or processed meat, preserved foods often high in salt increased the risk the infections (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn general, as showed in \u003cem\u003eTable\u0026nbsp;3\u003c/em\u003e, chewing khat, in hot drink of tea and/or coffee trend, using butter and margarine in meal preparation, less physical activity, hypertriglyceridemia, increased LDL-c, decreased HDL-c, hypercholesterolemia, dyslipidemia, being hypertensive, central obese, and abdominal pain symptoms were independently increase the odds of H. \u003cem\u003epylori\u003c/em\u003e infections.\u003c/p\u003e \u003cp\u003eIn the current study, the odd of H. \u003cem\u003epylori\u003c/em\u003e infection was nearly two times 1.83 more likely higher in khat chewers as compared with non-chewers. This finding is agreed with findings in Kenya and Ethiopia (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e), but contrary with other finding in Ethiopia (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). In the recent study and contrary to khat, alcohol conception is not associated with H. \u003cem\u003epylori\u003c/em\u003e infection. This is in line with finding in Germany (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e), but it is contrary with other finding in Ethiopia (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Likewise, the odds of H. \u003cem\u003epylori\u003c/em\u003e infection nearly 3 times more likely prevalent in hot drink of tea and/or coffee trend as compared with individuals not drink in hot. This finding agreed with findings in Ethiopia (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). Also, the odd of H. \u003cem\u003epylori\u003c/em\u003e infection was 2.5 times more likely higher in butter or ghee and margarine users as compared with vegetable oil users in meal preparation. Perhaps the content of butter or ghee and margarine might aggravate H. \u003cem\u003epylori\u003c/em\u003e infection as contrary vegetable oil might have the counter effects.\u003c/p\u003e \u003cp\u003eMoreover, in the current study, the odds of H. \u003cem\u003epylori\u003c/em\u003e infection was nearly 1.5 times more likely higher in not at all or less physical activity as compared with physical activity performing participants as per WHO recommendations. This finding agreed with finding done on Korean population (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Similarly, the odd of H. \u003cem\u003epylori\u003c/em\u003e infection was nearly 4 times more likely higher in central obese as compared with non-obese participants. This finding agreed with finding in China (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e), but contrary with other finding in China (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). Also, the odd of H. \u003cem\u003epylori\u003c/em\u003e infection was nearly 1.5 times more likely associated with hypertensive as compared with non-hypertensive participants. This finding is in line with the findings in Ethiopia (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e) and in China (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). Furthermore, the odd of H. \u003cem\u003epylori\u003c/em\u003e infection was 7 times more likely associated with upper abdominal pain (functional dyspepsia) as compared with non-dyspeptic participants. This finding again agrees with other findings in Ethiopia (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs summary, the current study is useful to understand the asymptomatically prevailing of H. \u003cem\u003epylori\u003c/em\u003e infection in the community, and it had a strong association with dyslipidemia. Moreover, other risks factors associated with the infection in the study community are identified. In addition, these findings are useful as a benchmark for researchers to look at the cause and effect of the association and health professionals to early diagnose, reverse its impacts and the aggravating risk factors.\u003c/p\u003e \u003cp\u003eDespite this study has many strengths, it also has some limitations. Since the study was a single-centered cross-sectional result, it is not used to infer national. Moreover, it is also important to mention its lack of including all age groups and telling the cause-and-effect relationship of the variables with health-related outcomes and economics.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eH. \u003cem\u003epylori\u003c/em\u003e infection is highly prevalent in the community. Moreover, H. pylori infection is significantly associated with the incidence of dyslipidemia. Similarly, in hot drink trend of tea and/or coffee, chewing khat, less physical activities, being hypertensive, central obese, dyspepsia. Therefore, early screening and decreasing those risk factors is promising and continuously emerging option to reduce the double burden H-\u003cem\u003epylori\u003c/em\u003e infection and dyslipidemia.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAOR\u003c/strong\u003e: Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eBMI\u003c/strong\u003e: Body Mass Index\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eBP\u003c/strong\u003e: Blood Pressure\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCI\u003c/strong\u003e: Confidence Interval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOR\u003c/strong\u003e: Crude Odds Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDDS\u003c/strong\u003e: Dietary Diversity Score\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eDM\u003c/strong\u003e: Diabetes Mellitus\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFBS\u003c/strong\u003e: Fasting Blood Sugar\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFD\u003c/strong\u003e: Functional Dyspepsia\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFGIDS\u003c/strong\u003e: Functional Gastrointestinal Disorders\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eH. \u003cem\u003epylori\u003c/em\u003e\u003c/strong\u003e: Helicobacter \u003cem\u003epylori\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eHDL-c\u003c/strong\u003e: High Density Lipoprotein cholesterol\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHEWs\u003c/strong\u003e: Health Extension Workers\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIHRPGD\u003c/strong\u003e: Institute of Health Research Post Graduate Development\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIRB\u003c/strong\u003e: Institutional Review Board\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;JUMC\u003c/strong\u003e: Jimma University Medical Center\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eLDL-c\u003c/strong\u003e: Low-Density Lipoprotein cholesterol\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eRBS:\u003c/strong\u003e Random Blood Sugar\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eSTEPS\u003c/strong\u003e: STEP wise approach to NCD risk factor surveillance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;T\u003csub\u003e2\u003c/sub\u003eDM\u003c/strong\u003e: Type 2 Diabetes Mellitus\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTAG/TG\u003c/strong\u003e: Triacylglycerol/Triglyceride\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;TC\u003c/strong\u003e: Total Cholesterol;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVITRAS\u003c/strong\u003e: Virtual Institute for Transdisciplinary Research and Scholarship Africa\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWC\u003c/strong\u003e: Waist Circumference\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWHO\u003c/strong\u003e: World Health Organization\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures performed in studies involving human participants were in accordance with the ethical standards of the Jimma Institutional Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted with approval from the Institutional Review Board (IRB), Institute of Health, Jimma University (Ref. No: IHRPGD595/2019).\u0026nbsp;All the participants were provided oral and written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability Data and Materials \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and/or analysed during this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research project supported by Postgraduate and Research Directorate of the Institute of Health, Jimma University and as seed money by Virtual Institute for Transdisciplinary Research and Scholarship Africa (VITRAS) of Texas Tech University in collaboration with Jimma University.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAuthors\u0026rsquo; contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBZ and TB participated on study conceptualization and study design. BZ, TB, KHA and DT, involved on supervision, data acquisition, analysis, and interpretation. BZ and MT performed laboratory works and interpretation. BZ, AE and ST took part in manuscript preparation and edition. Lastly, all authors gave final read and approval of the version to be published; and agree to be accountable for all aspects of the contents of the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank the supporter of this project and study participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Information \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Biomedical Sciences, Jimma University, Jimma City, Ethiopia\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Biomedical Sciences, Jimma University, Jimma City, Ethiopia\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eDepartment of Biomedical Sciences, Injibara University, Injibara Town, Ethiopia\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e4\u003c/sup\u003eDepartment Medical Laboratory, Jimma University, Jimma City, Ethiopia \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Nutrition and Dietetics, Jimma University, Jimma City, Ethiopia \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTesterman, T.L. and Morris, J. 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J Hum Hypertens 32, 158\u0026ndash;164 (2018). https://doi.org/10.1038/s41371-017-0028-8\u003c/li\u003e\n\u003cli\u003eYue L, Zhang R, Chen S, Duan G. Relationship between Helicobacter pylori and Incident Hypertension as well as Blood Pressure: A Systematic Review and Meta-Analysis. Dig Dis. 2023;41(1):124-137. doi: 10.1159/000524078. Epub 2022 Apr 4. PMID: 35378540.\u003c/li\u003e\n\u003cli\u003eFang Y, Xie H, Fan C. Association of hypertension with helicobacter pylori: A systematic review and meta‑analysis. PLoS One. 2022 May 19;17(5):e0268686. doi: 10.1371/journal.pone.0268686. Erratum in: PLoS One. 2022 Oct 24;17(10):e0276919. PMID: 35588432; PMCID: PMC9119435.\u003c/li\u003e\n\u003cli\u003eTaddesse G, Habteselassie A, Desta K, Esayas S, Bane A. Association of dyspepsia symptoms and Helicobacter pylori infections in private higher clinic, Addis Ababa, Ethiopia. Ethiop Med J. 2011 Apr;49(2):109-16. PMID: 21796910.\u003c/li\u003e\n\u003cli\u003eBelay Zawdie, KalkidanHassen Abate, Dessalegn Tamiru, TeferaBelachew. Abdominal Pain of FunctionalGastrointestinal Disorders in DietaryDiversity Patterns and Its Determinantsamong Healthy Adults in Jimma City,Southwest Ethiopia. Ethiop J Health Sci.2023;33(6):1027. doi: http://dx.doi.org/10.4314/ejhs. v33i6.13 \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables are available in the Supplementary Files section.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"H. pylori, Lipid profile, dyslipidemia, Jimma city, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-5237619/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5237619/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eInfection with H. Py\u003cem\u003elori\u003c/em\u003e triggers chronic inflammatory states along with dyslipidemia contribute of atherosclerosis. However, there is lack of emerging evidences of relationship of H. pylori infections and dyslipidemia among healthy adults. Therefore, this study aimed to investigate the relationship between H. \u003cem\u003epylori\u003c/em\u003e infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia. A total of 865 asymptomatic adults aged\u0026thinsp;\u0026gt;\u0026thinsp;18 years were enrolled in the study. From each study participants, 24-hrs dietary re-call, Rome-III based criteria abdominal pain symptoms, 5ml of venous blood and 20g of fresh stool was collected. From the study participants, positive H. \u003cem\u003epylori\u003c/em\u003e infection was, 170(19.7%) whereas dyslipidemia incidence was, 108(12.5). Factors significantly associated with the H. \u003cem\u003epylori\u003c/em\u003e positive test with an AOR (95% CI, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) were chewing khat, less physical activity, dyslipidemia, being hypertensive, central obesity and functional dyspepsia as compared to their normal counterparts. However, H. \u003cem\u003epylori\u003c/em\u003e infection was not associated with any of the dietary diversity scores. H. \u003cem\u003epylori\u003c/em\u003e infection is detected among asymptomatic population living in our study area. Moreover, H. \u003cem\u003epylori\u003c/em\u003e infection is significantly associated with dyslipidemia. Therefore, early screening and decreasing the risk factors are highly recommendable.\u003c/p\u003e","manuscriptTitle":"Relationship between helicobacter pylori infection and the incidence of dyslipidemia among asymptomatic adults in Jimma City, Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-26 09:49:40","doi":"10.21203/rs.3.rs-5237619/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2c24a69f-3a49-433f-ad1b-0b0efeabb1db","owner":[],"postedDate":"November 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-27T13:23:09+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-26 09:49:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5237619","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5237619","identity":"rs-5237619","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}