{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:27:59Z","timestamp":1793327279376,"version":"4.5.0"},"reference-count":68,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[2012,12,3]]},"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Persistent colonisation by\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      , and especially by\n                      <jats:italic>cagA-<\/jats:italic>\n                      positive strains, has been related to several health outcomes with effects in opposite directions. Thus, it is important to evaluate its influence on total and category-specific mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      We conducted prospective cohort analyses in a nationally representative sample of 9895 participants enrolled in the National Health and Nutrition Examination Survey III to assess the association of\n                      <jats:italic>H pylori<\/jats:italic>\n                      status with all-cause and cause-specific mortality. Analyses for the association of\n                      <jats:italic>H pylori cagA<\/jats:italic>\n                      positivity with mortality were conducted in 7384 subjects with data on\n                      <jats:italic>H pylori cagA<\/jats:italic>\n                      status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In older people (&gt;40.1\u2005years),\n                      <jats:italic>H pylori<\/jats:italic>\n                      was not associated with all-cause mortality (HR 1.00; 95% CI 0.84 to 1.18). There was an inverse association of\n                      <jats:italic>H pylori<\/jats:italic>\n                      status with stroke mortality (HR 0.69; 95% CI 0.44 to 1.08), and the inverse association was stronger for\n                      <jats:italic>H pylori cagA<\/jats:italic>\n                      positivity, with the HR of 0.45 (95% CI 0.27 to 0.76).\n                      <jats:italic>H pylori<\/jats:italic>\n                      was also strongly positively related to gastric cancer mortality. After we adjusted p values using the Benjamini\u2013Hochberg false discovery rate method to account for multiple comparisons, these associations remained, and\n                      <jats:italic>H pylori<\/jats:italic>\n                      status was not related to other outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our findings suggest that\n                      <jats:italic>H pylori<\/jats:italic>\n                      has a mixed role in human health, but is not a major risk factor for all-cause mortality.\n                    <\/jats:p>\n                  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