Chen Cheng, Xun Pengcheng, Tsinovoi Cari, He Ka
Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana.
Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana.
Ann Allergy Asthma Immunol. 2017 Aug;119(2):137-145.e2. doi: 10.1016/j.anai.2017.05.021. Epub 2017 Jun 19.
Helicobacter pylori (H pylori) infection has been suggested to be related to a decreased risk of asthma, but findings in the literature are inconsistent.
To quantitatively summarize the existing evidence on the association between H pylori infection and asthma risk.
The PubMed database was searched for observational studies of H pylori infection in relation to the risk of asthma published in English through May 2017. Measurements of association were pooled using a meta-analytic approach and expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs).
Twenty-four studies were identified in this meta-analysis, including 8 case-control studies composed of 1,247 cases and 2,410 controls, and 16 cross-sectional studies composed of 50,290 participants (4,185 cases and 46,105 noncases). The average H pylori infection rates were 40.01% and 48.74% in case-control and cross-sectional studies, respectively. Five studies subcategorized H pylori infection according to CagA status, in which 59.37% of H pylori-infected participants were identified as having CagA positivity. Helicobacter pylori infection was significantly inversely associated with the risk of asthma in case-control studies (OR 0.83, 95% CI 0.71-0.98) but was borderline significant in cross-sectional studies (OR 0.88, 95% CI 0.76-1.02). The observed inverse association persisted for CagA-positive H pylori infection (OR 0.77, 95% CI 0.63-0.93, P for interaction = .03) but not for CagA-negative strains (OR 1.08, 95% CI 0.66-1.78). No significant difference was observed across age or region subgroups.
The accumulated evidence supports that H pylori infection, especially CagA-positive H pylori infection, is inversely associated with the risk of asthma.
幽门螺杆菌（H pylori）感染被认为与哮喘风险降低有关，但文献中的研究结果并不一致。
定量总结关于幽门螺杆菌感染与哮喘风险之间关联的现有证据。
检索PubMed数据库，查找截至2017年5月以英文发表的关于幽门螺杆菌感染与哮喘风险关系的观察性研究。采用荟萃分析方法汇总关联测量值，并以比值比（OR）及95%置信区间（95%CI）表示。
该荟萃分析纳入24项研究，包括8项病例对照研究（1247例病例和2410例对照）和16项横断面研究（50290名参与者，4185例病例和46105例非病例）。病例对照研究和横断面研究中幽门螺杆菌的平均感染率分别为40.01%和48.74%。5项研究根据CagA状态对幽门螺杆菌感染进行亚分类，其中59.37%的幽门螺杆菌感染参与者被确定为CagA阳性。在病例对照研究中，幽门螺杆菌感染与哮喘风险显著负相关（OR 0.83，95%CI 0.71 - 0.98），但在横断面研究中接近显著（OR 0.88，95%CI 0.76 - 1.02）。观察到的负相关在CagA阳性幽门螺杆菌感染中持续存在（OR 0.77，95%CI 0.63 - 0.93，交互作用P = 0.03），但在CagA阴性菌株中不存在（OR 1.08，95%CI 0.66 - 1.78）。各年龄或地区亚组之间未观察到显著差异。
累积证据支持幽门螺杆菌感染，尤其是CagA阳性幽门螺杆菌感染，与哮喘风险呈负相关。
