infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis.

BACKGROUND

() is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of in the development of cholelithiasis remains inconclusive.

AIM

To investigate the potential association between infection and the development of cholelithiasis.

METHODS

We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about and cholelithiasis was also executed.

RESULTS

In our multi-center study, was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, = 0.049]. Furthermore, patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in -positive participants ( < 0.05). In the published articles, the cohort studies indicated was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, = 0.246). Besides, was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, = 0.033).

CONCLUSION

is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in patients.