Department of Gastroenterology and Hepatology, Beijing You'an Hospital Affiliated with Capital Medical University, Beijing, China.
Medicine (Baltimore). 2021 Aug 6;100(31):e26706. doi: 10.1097/MD.0000000000026706.
The relationship between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) is a matter of debate. Although it has been studied in many observational studies, the results remain controversial. Therefore, we performed a meta-analysis to assess the association between H pylori infection and risk of NAFLD.
We searched Pubmed, EMBASE, and Web of Science databases, from inception to September 10, 2020. Odds ratio (OR) and 95% confidence interval (CI) were pooled by random-effects model. The statistical heterogeneity among studies (I2-index), subgroup analyses, regression analyses, sensitivity analysis and the possibility of publication bias were assessed.
A total of seventeen studies involving 91,958 individuals were included in our meta-analysis. Meta-analysis of data from cross-sectional and case-control studies showed that H pylori infection was associated with increased risk of prevalent NAFLD (n = 15; involving 74,561 middle-aged individuals; OR1.38, 95% CI 1.23-1.55, I2 = 86.8%, P < .001). The results of meta-regression implicated that the study type and the case-control ratio impacted the total effect size. Funnel plot did not show significant publication bias. Meta-analysis of data from longitudinal studies showed that H pylori infection was also associated with increased NAFLD incidence (n = 2; involving 17397 individuals; OR 1.21, 95% CI 1.01-1.44, I2 = 6.5%, P = .301).
The results indicated that a positive association between H pylori infection and the risk of NAFLD. Further studies are required to strengthen the association and clarify the mechanism.
幽门螺杆菌（H. pylori）感染与非酒精性脂肪性肝病（NAFLD）之间的关系存在争议。尽管在许多观察性研究中进行了研究，但结果仍存在争议。因此，我们进行了一项荟萃分析，以评估 H pylori 感染与 NAFLD 风险之间的关联。
我们检索了 Pubmed、EMBASE 和 Web of Science 数据库，检索时间截至 2020 年 9 月 10 日。采用随机效应模型合并比值比（OR）和 95％置信区间（CI）。评估研究之间的统计异质性（I2 指数）、亚组分析、回归分析、敏感性分析和发表偏倚的可能性。
共有 17 项研究纳入了 91958 名个体，我们对其进行了荟萃分析。横断面和病例对照研究的数据荟萃分析表明，H pylori 感染与现患 NAFLD 的风险增加相关（n=15；涉及 74561 名中年个体；OR1.38，95％CI 1.23-1.55，I2=86.8％，P<.001）。荟萃回归结果表明，研究类型和病例对照比例影响总效应大小。漏斗图未显示出显著的发表偏倚。纵向研究的数据荟萃分析表明，H pylori 感染也与 NAFLD 发生率增加相关（n=2；涉及 17397 名个体；OR 1.21，95％CI 1.01-1.44，I2=6.5％，P=0.301）。
结果表明 H. pylori 感染与 NAFLD 风险之间存在正相关。需要进一步的研究来加强这种关联并阐明其机制。
