Original Article| Volume 15, ISSUE 1, P218-226.e1, January 2021

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Impaired cholesterol efflux capacity in patients with Helicobacter pylori infection and its relation with inflammation

  • Soudabeh Fallah
    Research Center of Pediatric Infectious Disease, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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  • Gunther Marsche
    Otto Loewi Research Center, Division of Pharmacology, Medical University of Graz, Austria
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  • Maryam Mohamadinarab
    Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
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  • Samaneh Mohassel Azadi
    Department of Clinical Biochemistry, Faculty of Medicine Tehran, University of Medical Sciences, Tehran, Iran
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  • Hooman Ghasri
    Department of Internal Medicine, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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  • Reza Fadaei
    Corresponding author. Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
    Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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  • Nariman Moradi
    Corresponding author. Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
    Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Research Center of Pediatric Infectious Disease, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Published:November 13, 2020DOI:


      • Non-ABCA1 CEC decreased in patients with H. pylori infection compared to controls.
      • ABCA1-mediated CEC decreased in patients with H. pylori compared to controls.
      • Non-ABCA1 and ABCA1-mediated CEC positively associated with apoA-I levels.
      • Non-ABCA1 and ABCA1-mediated CEC negatively associated with hsCRP levels.



      Gut microorganisms are associated with atherosclerosis and related cardiovascular disease. Helicobacter pylori (H. pylori) infection is associated with dyslipidemia and inflammation contributing to the progression of atherosclerosis.


      Several studies have reported reduced HDL-C levels in H. pylori infected patients, but HDL cholesterol efflux capacity (CEC) as the most important function of HDL has not been evaluated yet.


      This cross-sectional study was conducted with 44 biopsy confirmed H. pylori patients and 43 controls. ABCA1-mediated, non-ABCA1 and total CEC were measured in ApoB-depleted serum and levels of ApoA-I, ApoB and hsCRP were estimated using ELISA technique.


      Total and ABCA1 mediated-CEC were reduced in patients compared to controls, independent of age, sex, body mass index and HDL-C (p < 0.001), while non-ABCA1 CEC indicated no significant change between the groups. In addition, patients showed lower serum levels of ApoA-I but increased levels of hsCRP when compared to controls. Total CEC and ABCA1-mediated CEC positively correlated with ApoA-I and HDL-C, furthermore, ABCA1-mediated CEC as well as ApoA-I inversely correlated with hsCRP.


      The results of the present study indicate reduced CECs in H. pylori infected patients, especially ABCA1-mediated CEC which is associated with decreased ApoA-I and increased inflammation.


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