Abstract Pre-diabetes is a state of intermediate hyperglycaemia. Helicobacter (H) pylori infection is an established risk factor for pre-diabetes. This comparative cross-sectional study was done in Mayo Hospital Lahore from November 2015 to August 2016 in which 270 patients underwent upper gastrointestinal endoscopy with antral biopsy. An oral glucose tolerance test was done half to one hour after endoscopy. Patients were diagnosed having pre-diabetes according to American Diabetic Association criteria. Cases were divided into Group A and B based on the presence or absence of histopathological evidence of H. pylori respectively. Comparison was done to see the occurrence of pre-diabetes in H. pylori positive versus helicobacter negative dyspeptic patients. Results showed that 79 (58.52%) in Group-A and 62 (45.93%) in Group-B had pre- diabetes while remaining 56 (41.48%) in Group-A and 73 (54.07%) in Group-B had no findings of this morbidity, p value was calculated as 0.03 showing a significant difference. It was concluded that H. pylori infection is significantly associated with pre-diabetes. Keywords: Dyspepsia, Helicobacter pylori, Pre-diabetes, Association. Introduction Dyspepsia is a worldwide problem that affects 40% of adults, accounts for 8.3% of visits to primary care physicians. Approximately 10% of all patients presenting for endoscopy for gastrointestinal symptoms have dyspepsia. 1 Infection with Helicobacter (H) pylori is also a universal problem, more in developing countries. Helicobacter pylori, a gram-negative, spiral, flagellate bacillus which normally is a resident of gastric epithelium, can cause inflammatory cell infiltration in gastric mucosa that produces cytokines, which are not only responsible for local effects but can damage remote tissues causing extra digestive diseases like ischaemic heart disease, autoimmune thyroid disease, anaemia, idiopathic thrombocytopenic purpura, neurologic diseases and reactivation of TB. 2 Pre-diabetes is a disorder in which concentration of blood glucose is more elevated than normal levels but it is not high enough for a diagnosis of diabetes mellitus. Pre-diabetes occurs in patients having insulin resistance. Pre-diabetes ultimately converts in to type 2 diabetes mellitus. Pre-diabetes along with insulin resistance is an important etiology of metabolic syndrome. 3 Studies have shown that H pylori affect glucose homeostasis and insulin sensitivity in a negative way. Symptoms and quality of life may be improved with Helicobacter pylori eradication. 4 International Diabetes Federation (IDF) reported that in 2015 Pakistan had 7.0 million people of age group 20-79 years suffering from diabetes. By 2040, this number is expected to cross 14.4 million. In 2015, 7.9 million people had impaired glucose tolerance and this number is expected to cross 15.1 million in 2040. Moreover, 84,364 deaths were recorded due to diabetes in same year. 5 There have been few studies conducted recently which proposed that H pylori infection plays a role in pathogenesis of diabetes mellitus. 6 Local as well as international data is scanty regarding association of Helicobacter pylori and pre-diabetes. Present study was aimed to find an association between the occurrence of pre-diabetes in H. pylori positive and negative dyspeptic patients. Methods and Results This comparative cross-sectional study was done in West Medical Ward, Mayo Hospital, Lahore. Using non- probability purposive sampling and 270 patients (135 patients in each group) were selected. Patients with age more than or equal to 35 years, of either gender, with history of dyspepsia, bloating or epigastric discomfort for more than three months were included in the study. Patients with history of nonsteroidal anti- inflammatory drugs (NSAIDs) and/or alcohol intake, patients already on steroid or immunosuppressive or H. pylori eradication therapy, patients with diagnosed malignancy in previous medical records, patients with diagnosed chronic renal disease in previous medical records and patients having gallstones, were excluded. J Pak Med Assoc 939 SHORT REPORT Presence of pre-diabetes in Helicobacter pylori positive versus Helicobacter pylori negative patients having dyspepsia Umar Draz, 1 Rabia Rathore, 2 Nasir Farooq Butt, 3 Fawad Ahmad Randhawa, 4 Uzma Malik, 5 Tariq Waseem 6 1 Mayo Hospital, 2-6 King Edward Medical University, Lahore. Correspondence: Nasir Farooq Butt. Email: nasirfarooq75@gmail.com