Department of Endocrinology, The Third Clinical Medical College of China Three Gorges University/Gezhouba Central Hospital of Sinopharm, Yichang, Hubei Province, China.
Department of Geriatrics, The People's Hospital of China Three Gorges University/The First People's Hospital of Yichang, Yichang, Hubei Province, China.
Medicine (Baltimore). 2021 Nov 19;100(46):e27840. doi: 10.1097/MD.0000000000027840.
The relationship between Helicobacter pylori (H. pylori) infection and subclinical atherosclerosis has been confirmed, but these conclusions are still controversial. Therefore, we have performed a systematic review and meta-analysis to assess the association between H. pylori infection and subclinical atherosclerosis.
Databases including PubMed, Embase, Web of Science were searched for the articles on the association of carotid intima-media thickness or pulse wave velocity with H. pylori infection published up to January 1, 2020. Stata 12.0 was used to calculate standardized mean difference (SMD) and 95% confidence interval (95% CI); the I2 test was used to evaluate heterogeneity between studies and sensitivity analysis and subgroup analysis were used to explore the source of heterogeneity. Funnel plot, Begg test, and Egger test were used to estimate publication bias.
Data were extracted from 18 studies involving 6776 subjects with H. pylori positive and 7794 with H. pylori negative. H. pylori positive subjects is significantly associated with increased subclinical atherosclerosis as determined by carotid intima-media thickness (SMD: 0.376 mm; 95% CI: 0.178, 0.574; P < .001, I2 = 90.6%), pulse wave velocity (SMD: 0.320 m/s; 95% CI: 0.242, 0.398; P < .001, I2 = 52.6%), compared with H. pylori negative. Similar results were observed when subgroups analysis were stratified according to age, male ratio, geographical location, H. pylori diagnosis, and study design. Sensitivity analyses showed that our results were robust. The Begg test or Egger test showed no significant publication bias (all P > .05).
This meta-analysis confirmed a significant association between H. pylori and subclinical atherosclerosis, which will help H. pylori patients to establish effective strategies for the prevention and control of cardiovascular events.
幽门螺杆菌（H. pylori）感染与亚临床动脉粥样硬化之间的关系已得到证实，但这些结论仍存在争议。因此，我们进行了系统评价和荟萃分析，以评估 H. pylori 感染与亚临床动脉粥样硬化之间的关系。
检索了包括 PubMed、Embase、Web of Science 在内的数据库，以获取截至 2020 年 1 月 1 日发表的关于颈动脉内膜中层厚度或脉搏波速度与 H. pylori 感染相关性的文章。使用 Stata 12.0 计算标准化均数差（SMD）和 95%置信区间（95%CI）；使用 I2 检验评估研究之间的异质性，并进行敏感性分析和亚组分析以探索异质性的来源。使用漏斗图、贝叶斯检验和 Egger 检验评估发表偏倚。
从 18 项研究中提取了数据，共纳入 6776 例 H. pylori 阳性和 7794 例 H. pylori 阴性患者。H. pylori 阳性患者的亚临床动脉粥样硬化明显增加，其颈动脉内膜中层厚度（SMD：0.376 mm；95%CI：0.178，0.574；P<0.001，I2=90.6%）和脉搏波速度（SMD：0.320 m/s；95%CI：0.242，0.398；P<0.001，I2=52.6%）均显著高于 H. pylori 阴性患者。当根据年龄、男性比例、地理位置、H. pylori 诊断和研究设计进行亚组分析时，也观察到了类似的结果。敏感性分析表明我们的结果是稳健的。贝叶斯检验或 Egger 检验均未显示出显著的发表偏倚（均 P>0.05）。
本荟萃分析证实了 H. pylori 与亚临床动脉粥样硬化之间存在显著关联，这将有助于 H. pylori 患者制定有效的心血管事件预防和控制策略。
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