H.pylori; diabetes; health disparities; Mexican Americans; Blacks


Epidemiology | Nutritional and Metabolic Diseases | Public Health


Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in unadjusted model. After adjustment, H.pylori seropositivity was no longer associated with diabetes. Obesity (aOR 4.94, 95% CI 2.672,9.133) was associated with having type 2 diabetes compared to normal weight. Non-Hispanic Blacks (2.436, 95% CI 1.489,3.984) and Mexican Americans (1.896, 95% CI 1.002,3.587) had greater odds of diabetes compared to Whites. For nearly all stratified analyses, H.pylori did not have a significant association with type 2 diabetes although several other noteworthy findings emerged. A chance finding, where H.pylori was associated with greater likelihood of diabetes in Mexican Americans, 60-85, >25 BMI, may be worth a closer look.

Conclusion: Findings indicate weight status, obesity in particular, is the strongest predictor of diabetes followed by Black race. Stratified analyses suggest increasing racial disparities over the course of the life span.