Min Yu1, Yangbo Zhang2, Zhen Yang1, Jiangwu Ding3, Chuan Xie1, Nonghua Lu4. 1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. 2. Department of Neurology, The Second Affiliated Hospital of Nanchang University, Guangzhou, People's Republic of China. 3. Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. 4. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. Electronic address: lunonghua@163.com.
Abstract
BACKGROUND: Some studies have suggested an association between Helicobacter pylori infection and the risk of stroke, but the relationship remains controversial. The aim of this study was to obtain a more comprehensive estimate of H. pylori on the risk of stroke by performing a meta-analysis. METHODS: A computerized search of PubMed, EMBASE, and the Cochrane library (including CENTRAL) up to February 2014 was performed to identify eligible studies. Prospective studies reported that a multivariate-adjusted estimate for the association between H. pylori and stroke were included. A random-effects model was used to calculate the overall combined risk. RESULTS: Ten prospective observational studies (6 cohort studies, 4 nested case-control, or case-cohort studies within cohort studies) were included in the meta-analysis. The overall combined odds ratio for H. infection and stroke was .96 (95% confidence interval, .78-1.14). Similar results were yielded in patients with cytotoxin-associated gene-A seropositive strains. The combined estimates were robust across sensitivity analyses and had no observed publication bias. CONCLUSIONS: In conclusion, our formal meta-analysis indicated no strong association between H. pylori infection and stroke, neither in those with cytotoxin-associated gene-A-positive infection. We believe that future epidemiologic studies of H. pylori and stroke are unlikely to be fruitful.
BACKGROUND: Some studies have suggested an association between Helicobacter pyloriinfection and the risk of stroke, but the relationship remains controversial. The aim of this study was to obtain a more comprehensive estimate of H. pylori on the risk of stroke by performing a meta-analysis. METHODS: A computerized search of PubMed, EMBASE, and the Cochrane library (including CENTRAL) up to February 2014 was performed to identify eligible studies. Prospective studies reported that a multivariate-adjusted estimate for the association between H. pylori and stroke were included. A random-effects model was used to calculate the overall combined risk. RESULTS: Ten prospective observational studies (6 cohort studies, 4 nested case-control, or case-cohort studies within cohort studies) were included in the meta-analysis. The overall combined odds ratio for H. infection and stroke was .96 (95% confidence interval, .78-1.14). Similar results were yielded in patients with cytotoxin-associated gene-A seropositive strains. The combined estimates were robust across sensitivity analyses and had no observed publication bias. CONCLUSIONS: In conclusion, our formal meta-analysis indicated no strong association between H. pyloriinfection and stroke, neither in those with cytotoxin-associated gene-A-positive infection. We believe that future epidemiologic studies of H. pylori and stroke are unlikely to be fruitful.
Authors: Soo Hyun Jang; Hyejin Lee; Jun Suk Kim; Hyun Jung Park; Su Min Jeong; Sang-Hyun Lee; Hyun Ho Kim; Jin Ho Park; Dong Wook Shin; Jae Moon Yun; BeLong Cho; Hyung-Min Kwon Journal: Korean J Fam Med Date: 2015-09-18