Karn Wijarnpreecha1, Supavit Chesdachai2, Charat Thongprayoon3, Veeravich Jaruvongvanich4, Patompong Ungprasert5,6, Wisit Cheungpasitporn7. 1. Department of Internal Medicine, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA. dr.karn.wi@gmail.com. 2. Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 3. Department of Internal Medicine, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA. 4. Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA. 5. Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. 6. Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 7. Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Abstract
BACKGROUND/ OBJECTIVES: Hepatic encephalopathy is the common manifestation of decompensated cirrhosis. The association between Helicobacter pylori (H. pylori) infection and hepatic encephalopathy has been shown in many epidemiologic studies. This meta-analysis was conducted to summarize all available studies to estimate the association between H. pylori infection and hepatic encephalopathy. METHODS: A comprehensive literature review was conducted using MEDLINE and EMBASE database through March 2017 to identify studies that reported the association between H. pylori infection and hepatic encephalopathy. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. RESULTS: Of 15,233 studies, eleven studies (four cross-sectional, four case-control, and three cohort studies) met the eligibility criteria and were included in the meta-analysis. The pooled OR of hepatic encephalopathy in patients with H. pylori infection was 1.73 (95% CI 1.09-2.73) when compared with the patients without H. pylori infection. The association between H. pylori and hepatic encephalopathy was not statistically significant after the sensitivity analysis, excluding those using ELISA alone, with a pooled OR of 1.92 (95% CI 0.91-4.05, I 2 = 62%). There was no publication bias of overall included studies assessed by the funnel plots and Egger's regression asymmetry test. CONCLUSIONS: This study demonstrated a potential association between H. pylori infection and risk of hepatic encephalopathy. Future studies are required to assess the effect of chronicity of infection on the development of hepatic encephalopathy.
BACKGROUND/ OBJECTIVES:Hepatic encephalopathy is the common manifestation of decompensated cirrhosis. The association between Helicobacter pylori (H. pylori) infection and hepatic encephalopathy has been shown in many epidemiologic studies. This meta-analysis was conducted to summarize all available studies to estimate the association between H. pyloriinfection and hepatic encephalopathy. METHODS: A comprehensive literature review was conducted using MEDLINE and EMBASE database through March 2017 to identify studies that reported the association between H. pyloriinfection and hepatic encephalopathy. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. RESULTS: Of 15,233 studies, eleven studies (four cross-sectional, four case-control, and three cohort studies) met the eligibility criteria and were included in the meta-analysis. The pooled OR of hepatic encephalopathy in patients with H. pyloriinfection was 1.73 (95% CI 1.09-2.73) when compared with the patients without H. pyloriinfection. The association between H. pylori and hepatic encephalopathy was not statistically significant after the sensitivity analysis, excluding those using ELISA alone, with a pooled OR of 1.92 (95% CI 0.91-4.05, I 2 = 62%). There was no publication bias of overall included studies assessed by the funnel plots and Egger's regression asymmetry test. CONCLUSIONS: This study demonstrated a potential association between H. pyloriinfection and risk of hepatic encephalopathy. Future studies are required to assess the effect of chronicity of infection on the development of hepatic encephalopathy.
Authors: G P Gubbins; T E Moritz; L S Marsano; R Talwalkar; C J McClain; C L Mendenhall Journal: Am J Gastroenterol Date: 1993-11 Impact factor: 10.864
Authors: Raúl Herzog; María José Álvarez-Pasquin; Camino Díaz; José Luis Del Barrio; José Manuel Estrada; Ángel Gil Journal: BMC Public Health Date: 2013-02-19 Impact factor: 3.295
Authors: Xiao-Yuan Xu; Hui-Guo Ding; Wen-Gang Li; Ji-Dong Jia; Lai Wei; Zhong-Ping Duan; Yu-Lan Liu; En-Qiang Ling-Hu; Hui Zhuang; Chinese Society Of Hepatology; Chinese Medical Association Journal: World J Gastroenterol Date: 2019-09-28 Impact factor: 5.742