infection and peptic ulcer disease in cirrhotic patients: An updated meta-analysis.

BACKGROUND

Peptic ulcer (PU) is more prevalent in patients with liver cirrhosis. The role of () infection in the pathogenesis of PU in patients with cirrhosis is still not elucidated.

AIM

To perform a meta-analysis on the prevalence of infection and PU and their association in liver cirrhosis patients.

METHODS

We searched PubMed, EMBASE, Web of Science, Cochrane, CNKI, Wangfang, and CQVIP databases from inception to July 10, 2020. Odds ratio (OR) and 95% confidence interval (CI) were pooled using a random-effects model. The statistical heterogeneity among studies ( -index), subgroup analyses, regression analysis, sensitivity analysis, and the possibility of publication bias were assessed.

RESULTS

A total of 14 studies (13 cross-sectional studies; 1 cohort study) involving 2775 individuals (611 cases with PU and 2164 controls) were included in our meta-analysis. The prevalence of PU in patients with cirrhosis was 22%. The prevalence of infection was 65.6% in cirrhotic patients with PU, and 52.5% in those without. The pooled overall OR was 1.73 (95%CI: 1.16-2.56, = 66.2%, < 0.001, = 2.7, < 0.05). We did not find the cause of heterogeneity in the subgroup analyses and meta-regression analysis except for one study. Funnel plot did not show significant publication bias. The results of Begg's test and Egger's test indicated no evidence of substantial publication bias ( = 0.732, = 0.557).

CONCLUSION

There is a weakly positive association between infection and PU in patients with liver cirrhosis. It is suggested that infection may play a role in the pathogenesis of PU in liver cirrhotic patients.