This retrospective cross-sectional study evaluates the association between Helicobacter pylori infection and metabolic syndrome using health examination data from 5,218 adults at Nanjing First Hospital. Participants are divided into H. pylori-positive and negative groups based on urea breath test results. The primary outcome is metabolic syndrome prevalence (CDS 2020 criteria). Multivariable logistic regression will be used to assess the independent association, with subgroup analyses by age and sex.

Inclusion Criteria:

1. Age ≥18 years
2. Completed annual health examination at Nanjing First Hospital Health Management Center between May 1, 2024 and May 1, 2025
3. Underwent 13C or 14C urea breath test for H. pylori status assessment
4. Complete data on the following measurements: height, weight, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, triglycerides, and high-density lipoprotein cholesterol
5. No missing data on key study variables

Exclusion Criteria:

1. Missing key data on H. pylori test results (13C or 14C urea breath test)
2. Missing any of the following primary metabolic indicators: waist circumference, blood pressure (systolic/diastolic), fasting blood glucose, triglycerides, or HDL-cholesterol
3. Pregnancy or lactation
4. History of severe liver dysfunction
5. History of severe kidney dysfunction
6. History of malignancy

Adults (≥18 years) who completed annual health examinations at Nanjing First Hospital between May 1, 2024 and May 1, 2025, with complete data on H. pylori breath testing and metabolic syndrome components (waist circumference, blood pressure, fasting glucose, triglycerides, HDL-cholesterol). Pregnant/lactating women and those with severe organ dysfunction or malignancy were excluded.