{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T07:29:00Z","timestamp":1786778940564,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      infection is widespread worldwide and is associated with gastric cancer, posing global public health challenges. Previous studies have linked dyslipidemia with\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      infection but have generally described overall lipid changes, with limited lipid-profile analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To examine the associations between calculated lipid ratios and\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      infection among individuals without diabetes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants without diabetes who underwent the\n                      <jats:sup>13<\/jats:sup>\n                      C-urea breath test were included. We calculated lipid ratios (triglyceride\/total cholesterol, triglyceride\/low-density lipoprotein cholesterol (LDL-C), triglyceride\/high-density lipoprotein cholesterol (HDL-C), LDL-C\/HDL-C, non-HDL-C\/HDL-C, fasting plasma glucose\/HDL-C, uric acid\/HDL-C, and higher glycosylated hemoglobin\/HDL-C). Analyses included univariate and multivariate binary logistic regression, receiver operating characteristic analysis (area under the curve), restricted cubic spline modeling, and threshold analysis. The stability of the nonlinear relationship was further evaluated through sensitivity analyses using alternative knot configurations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 400 participants without diabetes (75 with\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection and 325 without\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection) were analyzed. Compared with participants without\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection, patients with\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection showed significant differences in neutrophil count, fasting plasma glucose, uric acid, total cholesterol, triglyceride, HDL-C, LDL-C, and non-HDL-C (p\u2009&lt;\u20090.05). LDL-C\/HDL-C was an independent risk factor for\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection (p\u2009=\u20090.007). Receiver operating characteristic analysis yielded an area under the curve of 0.713, a Youden index of 0.356, and an optimal cutoff value of 2.24 (sensitivity, 78.7%; specificity, 56.9%). In the primary three-knot model selected by Akaike information criterion, restricted cubic splines analysis indicated a significant, nonlinear association between LDL-C\/HDL-C\u2013\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      (p overall &lt; 0.001; p nonlinear \u2248 0.02). This nonlinear trend and the overall inflection pattern remained robust in sensitivity analyses (p overall &lt; 0.001), remaining statistically significant with five knots (p nonlinear\u2009=\u20090.041), although slightly attenuated with four knots (p nonlinear\u2009=\u20090.068). Piecewise logistic regression identified an inflection point at approximately1.94 (likelihood ratio p\u2009=\u20090.006). For LDL-C\/HDL-C\u2009&lt;\u20091.94, the risk of infection increased sharply with each unit increase (odds ratio\u2009=\u200968.00, 95% confidence interval: 1.83\u20132521.00, p\n                      <jats:bold>\u2009=\u2009<\/jats:bold>\n                      0.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      LDL-C\/HDL-C is an independent, nonlinear predictor of\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      infection in individuals without diabetes and may serve as a practical biomarker for risk stratification. Implications include lipid-centered prevention through dietary and lifestyle interventions. Larger prospective studies are needed to validate causality and assess applicability across metabolic phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261476154","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:14:36Z","timestamp":1786529676000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of metabolic variants with\n                    <i>Helicobacter pylori<\/i>\n                    infection risk: A retrospective cross-sectional study"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3828-4490","authenticated-orcid":false,"given":"Manli","family":"Yan","sequence":"first","affiliation":[{"name":"Guangzhou University of Traditional Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Guangzhou University of Traditional Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Guangzhou University of Traditional Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyang","family":"Yang","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiu","family":"Chen","sequence":"additional","affiliation":[{"name":"Sun Yat-Sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Hospital of Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Fu","sequence":"additional","affiliation":[{"name":"900th Hospital of Joint Logistics Support Force"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Huang","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Hospital of Chinese Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.028"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3018326"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12165"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/481365"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1220347"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234433"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00417"},{"key":"e_1_3_2_9_2","article-title":"Postoperative high-density lipoprotein cholesterol level: an independent prognostic factor for gastric cancer","volume":"12","author":"Li CX","year":"2022","unstructured":"Li CX, Fu Y, Li QW, et al. 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