Ben-Gang Zhou1, Huai-Jie Yang2, Wei Xu3, Kai Wang4, Peng Guo5, Yao-Wei Ai1. 1. Department of Gastroenterology, The People's Hospital of China Three Gorges University and The First People's Hospital of Yichang, Yichang, Hubei Province, China. 2. Department of Science and Education, The People's Hospital of China Three Gorges University and The First People's Hospital of Yichang, Yichang, Hubei Province, China. 3. Shanghai University of Traditional Chinese Medicine, Shanghai, China. 4. Department of Clinical Immunology and Rheumatology, The People's Hospital of China Three Gorges University and The First People's Hospital of Yichang, Yichang, Hubei Province, China. 5. Department of Hepatobiliary Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China.
Abstract
BACKGROUND: The association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) has been shown in many observational studies, but these conclusions remain controversial. Hence, we performed a meta-analysis to elucidate the association. METHODS: A comprehensive search was conducted on relevant studies published from inception to December 31, 2018, in PubMed, EMBASE, and Web of Science databases. Odds ratio (OR) with 95% confidence interval (95% CI) were pooled by random-effect model, generic inverse variance method. Subgroup and sensitivity analyses were also done. Publication bias was estimated by the funnel plot, Begg's test, and Egger's test. RESULTS: Fifteen studies (eleven cross-sectional, two case-control, and two cohort studies) were included in this meta-analysis. The pooled OR of NAFLD in patients with H. pylori infection was 1.19 (95% CI: 1.11-1.29, P < 0.00001) when compared with the patients without H. pylori infection. Similar results were observed when the subgroup analyses were stratified by different geographical locations, study designs, and confounders adjustment. In subgroup analysis stratified by different H. pylori testing methods, the correlation still exists when using UBT, serology, RUT, or SAT, but there was no statistically significant difference when using multiple detection methods (OR = 2.96, 95% CI: 0.37-23.94, P = 0.31). Sensitivity analyses showed that our results were robust. No evidence of substantial publication bias was detected. CONCLUSIONS: Current evidence indicated that a positive association between H. pylori infection and the risk of NAFLD. Further prospective studies are warranted to strengthen the association and to clarify whether there is a causative link between them.
BACKGROUND: The association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) has been shown in many observational studies, but these conclusions remain controversial. Hence, we performed a meta-analysis to elucidate the association. METHODS: A comprehensive search was conducted on relevant studies published from inception to December 31, 2018, in PubMed, EMBASE, and Web of Science databases. Odds ratio (OR) with 95% confidence interval (95% CI) were pooled by random-effect model, generic inverse variance method. Subgroup and sensitivity analyses were also done. Publication bias was estimated by the funnel plot, Begg's test, and Egger's test. RESULTS: Fifteen studies (eleven cross-sectional, two case-control, and two cohort studies) were included in this meta-analysis. The pooled OR of NAFLD in patients with H. pyloriinfection was 1.19 (95% CI: 1.11-1.29, P < 0.00001) when compared with the patients without H. pyloriinfection. Similar results were observed when the subgroup analyses were stratified by different geographical locations, study designs, and confounders adjustment. In subgroup analysis stratified by different H. pylori testing methods, the correlation still exists when using UBT, serology, RUT, or SAT, but there was no statistically significant difference when using multiple detection methods (OR = 2.96, 95% CI: 0.37-23.94, P = 0.31). Sensitivity analyses showed that our results were robust. No evidence of substantial publication bias was detected. CONCLUSIONS: Current evidence indicated that a positive association between H. pyloriinfection and the risk of NAFLD. Further prospective studies are warranted to strengthen the association and to clarify whether there is a causative link between them.
Authors: Christian S Alvarez; Andrea A Florio; Julia Butt; Alvaro Rivera-Andrade; María F Kroker-Lobos; Tim Waterboer; Maria Constanza Camargo; Neal D Freedman; Barry I Graubard; Mariana Lazo; Eliseo Guallar; John D Groopman; Manuel Ramírez-Zea; Katherine A McGlynn Journal: Helicobacter Date: 2020-10-02 Impact factor: 5.182
Authors: Mei-Yan Xu; Jia-Hui Ma; Juan Du; Jian Yin; Lan Liu; Fuqiang Cui; Qing-Bin Lu Journal: Gastroenterol Res Pract Date: 2020-01-25 Impact factor: 2.260