# Infection with Helicobacter pylori and the age at onset of coeliac disease in the “HUNT4” survey

## TL;DR

This study found that Helicobacter pylori infection and specific antigens may be linked to a later age of coeliac disease diagnosis.

## Contribution

The study identifies a potential link between H. pylori antigens and delayed coeliac disease onset.

## Key findings

- H. pylori-positive individuals were diagnosed with coeliac disease at an older age than negative individuals.
- Higher antibody levels against GroEL were associated with an older age at sampling in undiagnosed coeliac disease cases.
- Antigens like GroEL, gGT, and UreA appeared to contribute to the observed age differences.

## Abstract

This study aimed to determine whether H. pylori or its antigens affect the age at which coeliac disease (CeD) was diagnosed. Participants over 20 years old from the HUNT4 survey were screened for CeD by measuring serum immunoglobulin A and immunoglobulin G antibodies against transglutaminase-2. H. pylori status was defined by detecting H. pylori-specific immunoglobulin G.

H. pylori + participants had a mean age of 62.3 years, compared to 54.8 years for negative participants. In those with previously undiagnosed CeD (n = 43), higher antibody levels against GroEL were associated with an older age at sampling (67.2 years for GroEL-positive vs. 50.8 years for negative). Smaller age differences were noted for gGT (6.0 years), UreA (8.6 years), and HpcC (6.4 years), while vacA and cagA showed only minor differences. Participants with CeD and H. pylori + were older than those who were H. pylori−. The presence of antigens such as GroEL, gGT, and UreA appeared to be associated with this age difference. Aside from H. pylori infection in childhood, a cohort effect of H. pylori infection may partly explain the differences.