The Relation of Microalbuminuria and Helicobacter Pylori cagA Gene in Patients with Type 2 Diabetes

Diabetes mellitus is the most prevalent metabolic disorder worldwide with many subsequent medical complications. An important complication of diabetes is microalbuminuria which is an important indication for development of diabetic nephropathy. The prevalence of diabetic nephropathy in patients with type 2 diabetes has been estimated to be 47%. Since the disorder initiates with microalbuminuria, early detection and prevention are of vital importance. Helicobacter pylori infection is more prevalent in diabetic patients due to their low immune tolerance. The cagA positive genotype is reported to be effective in microalbuminuria development in type 2 diabetic patients. In this study, we investigated the relation of H. pylori cagA virulence factor with microalbuminuria in patients with type 2 diabetes.

This study included 88 patients with type 2 diabetes. Microalbuminuria was present in 60 subjects and absent in the other 28. Stool samples were collected from all patients and DNA was extracted using QIAamp DNA Stool Mini Kit. In order to detect H. pylori infection, a nested polymerase chain reaction (PCR) protocol was developed and all H. pylori positive samples were genotyped for cagA positivity.

Overall, 16 patients (18.2%) were detected to be H. pylori positive out of whom 12 had microalbuminuria (75%) and 4 (25%) did not. CagA positivity was detected in 3 subjects who belonged to the group with microalbuminuria.

In the population studied and the sample size used, no correlation was found between cagA gene and microalbuminuria in patients with type 2 diabetes.