{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:56:49Z","timestamp":1753891009289,"version":"3.41.2"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017549","name":"Science and Technology Innovation 2025 Major Project of Ningbo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017549","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> has been increasingly implicated in extra-gastric diseases. Current evidence regarding the association between serum thyroid-stimulating hormone (TSH), thyroxine (T4), and <jats:italic>H. pylori<\/jats:italic> infection remains inconclusive. Consequently, this study aimed to explore the correlation between TSH and T4 levels and <jats:italic>H. pylori<\/jats:italic> infection in a US-based population sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the US National Health and Nutrition Examination Survey (NHANES), comprising 971 participants aged 30\u201385 years from 1999 to 2000, were analyzed. Binary logistic regression was employed to analyze the correlation between <jats:italic>H. pylori<\/jats:italic> and TSH and T4 levels. The impact of TSH and T4 on <jats:italic>H. pylori<\/jats:italic> infection was further assessed using restricted cubic spline (RCS) analysis. In addition, subgroup analyses stratified by sex and age were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Subjects with <jats:italic>H. pylori<\/jats:italic> seropositivity demonstrated lower serum TSH levels and higher serum T4 levels compared to those with <jats:italic>H. pylori<\/jats:italic> seronegativity. A significant positive correlation was identified between <jats:italic>H. pylori<\/jats:italic> seropositivity and T4 levels with increasing quartiles of hormonal levels in both univariate regression models (Q4 vs. Q1: OR = 1.483; 95% CI, 1.033\u20132.129) and multivariate regression models (Q4 vs. Q1: OR = 1.004; 95% CI, 0.981\u20131.026). Conversely, a negative correlation was observed between <jats:italic>H. pylori<\/jats:italic> seropositivity and TSH levels with increasing quartiles of hormonal levels in univariate regression models (Q4 vs. Q1: OR = 0.579; 95% CI, 0.403\u20130.831) and in multivariate regression models (Q4 vs. Q1: OR = 0.580; 95% CI, 0.389\u20130.866). In stratified analyses, the adjusted association of serum T4 levels with <jats:italic>H. pylori<\/jats:italic> seropositivity was statistically significant among men (T4: Q4 vs. Q1: OR = 2.253; 95% CI, 1.311\u20133.873), age over 68 years in TSH levels (Q4 vs. Q1: OR = 0.434; 95% CI, 0.206\u20130.911), and age 41\u201354 years in T4 levels (Q4 vs. Q1: OR = 4.965; 95% CI, 2.071\u201311.903). RCS analysis revealed a non-linear relationship between TSH levels and <jats:italic>H. pylori<\/jats:italic> infection. Notably, when TSH &amp;lt; 0.98 IU\/ml, the likelihood of <jats:italic>H. pylori<\/jats:italic> infection significantly increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower TSH and higher T4 levels were associated with <jats:italic>H. pylori<\/jats:italic> infection, particularly among men and elderly individuals.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1482073","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T05:12:19Z","timestamp":1738559539000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between Helicobacter pylori infection, serum thyroid-stimulating hormone, and thyroxine in the National Health and Nutrition Examination Survey 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