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Background   Helicobacter pylori  ( H. pylori ), Gram negative microaerophilic bacteria, is a well-known pathogen of many gastrointestinal diseases. But several emerging evidences suggest it role in numerous other extra-gastric diseases. The current study investigates the relationship between  H. pylori  infection and sarcopenia, a clinical condition characterized by the loss of mass and function of skeletal muscle. A total of 3453 eligible participants from the Third National Health and Nutrition Examination Survey (NHANES III), the United States, were enrolled. Based on the serum laboratory results, subjects were categorized into three groups: normal (without evidence of any  H. pylori  infection), anti- H. pylori  IgG positive [ H. pylori  (+)], and concurrent anti- H. pylori  IgG and anti-cytotoxin-associated gene A IgG positive [CagA (+)]. Sarcopenia was determined as having a skeletal muscle index (SMI) value that is more than 1 standard deviation away from the mean value of sex-specific, healthy young adults between 20 and 39 years old. Risk of sarcopenia and its components are compared between subgroups.    Results  Odds ratios (OR) for confirmed diagnosis of sarcopenia were higher in  H. pylori  (+) (OR = 2.052, 95% CI 1.697–2.481, p < 0.001) and CagA (+) (OR = 1.585, 95% CI 1.278–1.965, p < 0.001) groups. Moreover, negative beta regression coefficient of SMI were shown in  H. pylori  (+) (β: − 0.023, p < 0.001) and CagA (+) (β: − 0.017, p < 0.001). Sub-analyses which categorized participants by gender revealed that absolute value of beta regression coefficient for SMI were higher in female in  H. pylori  (+) subgroup (β: − 1.745 in male and − 2.942 in female, p were both < 0.001), and the CagA (+) subgroup (β: − 1.407 in male and − 2.159 in female, p were both < 0.001).    Conclusions  Positive serum  H. pylori  infectious markers including anti- H. pylori  antibody and CagA seropositivity are correlated with sarcopenia and low muscle quantity. Therefore,  H. pylori  eradication therapy may bring benefits to sarcopenia patients with concurrent active  H. pylori  infection.

Detrimental relevance of Helicobacter pylori infection with sarcopenia