Upala Sikarin, Sanguankeo Anawin, Saleem Sheikh A, Jaruvongvanich Veeravich
aDepartment of Internal Medicine, Bassett Medical Center, Columbia University College of Physicians and Surgeons, Cooperstown, New York bDepartment of Internal Medicine, University of Hawaii, Honolulu, Hawaii, USA cDepartment of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Salaya dDepartment of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Eur J Gastroenterol Hepatol. 2017 Feb;29(2):153-159. doi: 10.1097/MEG.0000000000000774.
Previous studies have shown a close relationship between Helicobacter pylori (H. pylori), insulin resistance, and altered metabolic parameters. However, the effects of H. pylori eradication on these conditions remain controversial. We carried out a systematic review and meta-analysis to evaluate the effects of H. pylori eradication on insulin resistance and metabolic parameters.
We searched CENTRAL, MEDLINE, and EMBASE databases from their inception to July 2016. Insulin resistance (HOMA-IR), body weight (BW), BMI, waist circumference, triglycerides (TG), high-density and low-density lipoprotein-cholesterol (HDL-C and LDL-C), and fasting blood glucose (FBG) were compared between patients with and without H. pylori eradication using a random-effects model. We reported pooled mean differences (MD) and 95% confidence intervals (CI) for the change in outcomes.
Data from five studies showed no difference in HOMA-IR after H. pylori eradication (pooled MD=-0.52, 95% CI: -1.47 to 0.42). Eradication significantly increased BMI (MD=0.36, 95% CI: 0.11-0.60) and BW (MD=1.1, 95% CI: 0.8-1.5), but had no significant effects on TG, LDL-C, HDL-C, or FBG.
H. pylori eradication does not improve insulin resistance, TG, HDL-C, LDL-C, or FBG, but may increase BW and BMI. Further studies are needed to clarify the effect of H. pylori eradication on metabolism.
既往研究表明幽门螺杆菌（H. pylori）、胰岛素抵抗与代谢参数改变之间存在密切关系。然而，根除幽门螺杆菌对这些情况的影响仍存在争议。我们进行了一项系统评价和荟萃分析，以评估根除幽门螺杆菌对胰岛素抵抗和代谢参数的影响。
我们检索了CENTRAL、MEDLINE和EMBASE数据库，检索时间从各数据库建库至2016年7月。采用随机效应模型比较根除幽门螺杆菌的患者与未根除幽门螺杆菌的患者之间的胰岛素抵抗（HOMA-IR）、体重（BW）、BMI、腰围、甘油三酯（TG）、高密度和低密度脂蛋白胆固醇（HDL-C和LDL-C）以及空腹血糖（FBG）。我们报告了结局变化的合并平均差（MD）和95%置信区间（CI）。
五项研究的数据显示，根除幽门螺杆菌后HOMA-IR无差异（合并MD=-0.52，95%CI：-1.47至0.42）。根除显著增加了BMI（MD=0.36，95%CI：0.11-0.60）和BW（MD=1.1，95%CI：0.8-1.5），但对TG、LDL-C、HDL-C或FBG无显著影响。
根除幽门螺杆菌并不能改善胰岛素抵抗、TG、HDL-C、LDL-C或FBG，但可能增加BW和BMI。需要进一步研究以阐明根除幽门螺杆菌对代谢的影响。
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