{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:52Z","timestamp":1792787272387,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Key R & D Plans of Shaanxi Province","award":["2021SF-317"],"award-info":[{"award-number":["2021SF-317"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,28]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      is a type of Gram-negative microaerobic bacteria that inhabits the gastric mucosal epithelium. It can cause various gastrointestinal diseases including gastritis, peptic ulcer and gastric cancer. White blood cells (WBC) are common immune cells, the increase in whose countoften indicates the presence of an infection. Currently, the relationship between\n                      <jats:italic>H. pylori<\/jats:italic>\n                      and WBC count remains full of controversy. This study aims to further elucidate the effects of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      on WBC count in a population undergoing physical examination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      A total of 864 participants who underwent physical examination and\n                      <jats:sup>14<\/jats:sup>\n                      C urea breath test (UBT) were retrospectively enrolled in this study from January to June 2021. The overall population was divided into\n                      <jats:italic>H. pylori<\/jats:italic>\n                      -negative (Hp\u2212) and\n                      <jats:italic>H. pylori<\/jats:italic>\n                      -positive (Hp+) groups based on the disintegration per minute (DPM) value detected by UBT. Spearman\u2019s correlation analysis was used to assess the correlation between DPM and WBC count. General linear regression models were applied to assess the potential factors contributing to the increase in WBC count. Generalised additive model (GAM) was performed to identify the non-linear relationship between DPM and WBC count. Additionally, a piecewise linear regression was used to examine the threshold effect of the DPM on WBC count.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      403 subjects were diagnosed with\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection. The WBC and platelet (PLT) counts in the Hp+ group were significantly higher than those in the Hp\u2212 group. Additionally, the prevalence of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection gradually increased with the WBC count quartiles (38.89% and 54.67% in quartile 1 and quartile 4, respectively). Spearman\u2019s correlation analysis showed that the DPM value significantly correlated with WBC count (r=0.089, p=0.009) and PLT count (r=0.082, p=0.017). The linear model revealed a positive independent association of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection and DPM with WBC count (\u03b2\n                      <jats:sub>Hp+<\/jats:sub>\n                      =0.398 (95% CI 0.170, 0.625), p&lt;0.001; \u03b2\n                      <jats:sub>DPM<\/jats:sub>\n                      =0.002 (95% CI 0.000, 0.0030), p=0.018). The results of the GAM and the piecewise linear regression suggested that the cut-off points of the association between DPM and WBC count were 40 and 155 of DPM, that is, the effect of DPM on WBC count varied with the difference of DPM &lt;40, 40\u2013155, and &gt;155 (\u03b2\n                      <jats:sub>DPM<\/jats:sub>\n                      =\u22120.005 (95%\u2009CI \u22120.017, 0.007), p=0.423; \u03b2\n                      <jats:sub>DPM<\/jats:sub>\n                      =0.006 (95%\u2009CI 0.002, 0.013), p=0.047; and \u03b2\n                      <jats:sub>DPM<\/jats:sub>\n                      =\u22120.007 (95%\u2009CI \u22120.012, \u20130.002), p=0.004, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection was independently and positively correlated with WBC count; however, the effect of DPM on WBC count varied across different WBC count intervals, suggesting distinct immunological responses at different stages of infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080980","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T23:07:04Z","timestamp":1730588824000},"page":"e080980","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Association of\n                    <i>Helicobacter pylori<\/i>\n                    infection and white blood cell count: a cross-sectional study"],"prefix":"10.1136","volume":"14","author":[{"given":"Rui","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. Faculty of Life Sciences and Medicine, Northwest University, Guangming Road, Shenmu, China"},{"name":"Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Medical Research Center, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. Faculty of Life Sciences and Medicine, Northwest University, Guangming Road, Shenmu, China"},{"name":"Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. Faculty of Life Sciences and Medicine, Northwest University, Guangming Road, Shenmu, China"},{"name":"Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. 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Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaofei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. Faculty of Life Sciences and Medicine, Northwest University, Guangming Road, Shenmu, China"},{"name":"Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education. Faculty of Life Sciences and Medicine, Northwest University, 229 Taibai North Road, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenmu Hospital, The Affiliated Hospital of Northwest University. 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