Helicobacter pylori infection is independently associated with triglyceride levels: a propensity score–matched cross-sectional study

Background Helicobacter pylori ( H. pylori ) infects more than 50% of the global population and is associated with a variety of upper gastrointestinal diseases. In recent years, studies have suggested that H. pylori infection may contribute to metabolic syndrome and dyslipidemia. Objective To investigate the association between H. pylori infection and serum lipid levels. Methods We enrolled 678 participants who underwent both the 13 C-urea breath test and a lipid profile test at our hospital in 2024. We collected demographic and clinical characteristics, breath test results, and serum lipid profiles. H. pylori positivity was defined as a DOB value ≥ 4‰. We performed 1:1 propensity score matching (PSM) on key covariates (sex, age, and body mass index [BMI]), yielding 214 H. pylori -positive participants and 214 H. pylori -negative participants. We compared serum lipid levels between the two matched groups. We used paired fixed-effects linear regression to evaluate the independent association between H. pylori infection and triglyceride (TG) levels. Results Triglyceride (TG) levels remained higher in the H. pylori -positive group. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) did not differ significantly between the two groups. In the adjusted model controlling for age, sex, smoking, alcohol use, hypertension, and diabetes, H. pylori infection was independently associated with higher TG levels. Conclusion H. pylori infection is independently associated with elevated triglyceride levels. These findings highlight the potential role of H. pylori in metabolic risk assessment and in the design of intervention studies. The causal relationship requires further confirmation in prospective and mechanistic studies.