Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Helicobacter. 2021 Apr;26(2):e12781. doi: 10.1111/hel.12781. Epub 2021 Jan 19.
Previous studies have revealed the association between Helicobacter pylori (H. pylori) and diabetes mellitus, but conflicts still exist. The present study tried to investigate the underlying link between these two diseases by making comprehensive analyses of the impact of diabetes on H. pylori eradication and the influence of H. pylori eradication on diabetes.
We systematically searched relevant studies from PubMed, Cochrane Library, Web of Science, and Embase updated to April 23, 2020. Studies examining the association between H. pylori eradication and diabetes were included. Pooled odds ratio (OR) and weighted mean differences (WMD) were calculated for different results.
Among the 2125 retrieved studies, 36 studies were included. Patients with type 2 diabetes mellitus (T2DM) have higher risk of H. pylori eradication failure than the non-diabetic one (OR = 2.59, 95% CI 1.82-3.70). Body mass index (BMI) was identified as a major factor affecting the efficacy of H. pylori eradication in diabetics, and better glycemic control was also found in eradication succeed patients (WMD: 0.51, 95% CI 0.20-0.81). Moreover, after eradication of H. pylori, improvement of HbA1c was proved (WMD = -0.33, 95% CI -0.65 to -0.02) in T2DM.
A higher risk of H. pylori eradication failure in T2DM was confirmed, and it was associated with BMI and glycemic control. Moreover, we also provided evidence that H. pylori eradication could improve glycemic control in patients with T2DM, which indirectly reflect the interaction between H. pylori and the diabetes.
既往研究已经揭示了幽门螺杆菌（H. pylori）与糖尿病之间的关联，但仍存在争议。本研究旨在通过综合分析糖尿病对 H. pylori 根除的影响以及 H. pylori 根除对糖尿病的影响，探讨这两种疾病之间的潜在联系。
我们系统地检索了 PubMed、Cochrane Library、Web of Science 和 Embase 数据库中截至 2020 年 4 月 23 日的相关研究。纳入了评估 H. pylori 根除与糖尿病之间关联的研究。对不同结果进行了汇总优势比（OR）和加权均数差（WMD）分析。
在检索到的 2125 篇文献中，共有 36 项研究被纳入。与非糖尿病患者相比，2 型糖尿病（T2DM）患者的 H. pylori 根除失败风险更高（OR=2.59，95%CI 1.82-3.70）。体重指数（BMI）是影响糖尿病患者 H. pylori 根除疗效的主要因素，并且根除成功的患者血糖控制更好（WMD：0.51，95%CI 0.20-0.81）。此外，根除 H. pylori 后，T2DM 患者的糖化血红蛋白（HbA1c）水平得到改善（WMD=-0.33，95%CI-0.65 至-0.02）。
T2DM 患者的 H. pylori 根除失败风险更高，与 BMI 和血糖控制有关。此外，我们还提供了证据表明 H. pylori 根除可改善 T2DM 患者的血糖控制，这间接反映了 H. pylori 与糖尿病之间的相互作用。
