Is Helicobacter pylori Infection Associated with Celiac Disease? A Meta-analysis.

BACKGROUND

Some studies have reported the correlation between Helicobacter pylori and celiac disease (CD), but the results lack consistency. This meta-analysis aimed to quantify the relationship between H. pylori and CD. In addition, the study also analyzed the impact of H. pylori on the symptoms and classification of CD.

METHODS

Studies published up to September 1, 2020 on 3 databases - EMBASE, MEDICINE, and PubMed - were searched. The statistical data of articles which met the requirements were collated and extracted.

RESULTS

Twenty-five papers and 141 355 participants were finally enrolled. The results showed that the H. pylori infection rate of CD patients was 0.57 times greater compared to controls (OR = 0.57, 95% CI [0.44, 0.75]), while statistical differences were also seen in the subgroups of children (OR = 0.53, 95% CI [0.33, 0.85]) and adults (OR = 0.63, 95% CI [0.49, 0.81]). Furthermore, patients having CD with H. pylori were more likely to have symptoms of abdominal pain, diarrhea, and distension (OR = 2.5, 95% CI [1.35, 4.62]) (OR = 1.56, 95% CI [1.09, 2.24]) (OR = 2.75, 95% CI [1.74, 4.35]). However, H. pylori has no effect on CD classification.

CONCLUSION

The study confirmed that there is a correlation between H. pylori and CD, but the causality cannot be clarified. A demonstration of a causal role of H. pylori in CD in future prospective studies could have important therapeutic implications.