Cytotoxin-associated gene a strains of Helicobaciter pylori represent a risk factor for the development of microalbuminuria in type 2 diabetes

The reasons why diabetic patients with microalbuminuria have marked endothelial damage (1,2) and an increased risk of atherosclerosis (3,4) are unclear. Infection with Helicobacter pylori, especially with strains carrying the cytotoxin-associated gene A (CagA), might represent a causal factor, since anti-CagA antibodies elicited by infection may cross-react with endothelial antigens (5), increasing the vascular damage associated with diabetes itself and consequent albumin leakage. Furthermore, infection might induce a persistent systemic inflammatory response, which is a recognized risk factor for atherosclerosis (6). In this study, we investigated the possible pathogenetic role of CagA-positive H. pylori strains in type 2 diabetic patients with microalbuminuria.