Effect of Helicobacter pylori eradication on iron deficiency.
BACKGROUND
Iron deficiency (ID) is still a great challenge to health care worldwide. Results of randomized controlled trials (RCTs) evaluating the effect of Helicobacter pylori (H. pylori) eradication on ID are contradictory. This study aimed to evaluate the effect of H. pylori eradication on ID with a meta-analysis of RCTs.


METHODS
Five electronic databases were searched for RCTs evaluating the effect of H. pylori eradication on ID. Summary effects were assessed with the methods recommended by the Cochrane Collaboration.


RESULTS
Eight studies involving 800 participants were included in this meta-analysis. The overall analysis showed that H. pylori eradication accelerated the improvement of ferritin levels in ID people (mean difference (MD), 7.74 microg/L; 95%CI, 4.61 to 10.88; P < 0.00001). In a subgroup analysis, H. pylori eradication accelerated the improvement of ferritin levels one month (MD, 7.00 microg/L; 95%CI, 1.72 to 12.28; P = 0.009) and two months (MD, 9.80 microg/L; 95%CI, 2.22 to 17.40; P = 0.01) after the initiation of treatment. However, H. pylori eradication did not show a beneficial effect on the improvement of ferritin levels three months (MD, 7.20 microg/L; 95%CI, -3.25 to 17.65; P = 0.18), one year (MD, 10.17 microg/L; 95%CI, -1.00 to 21.34; P = 0.07) and forty months (MD, 1.00 microg/L; 95%CI, -0.57 to 2.57; P = 0.21) after the initiation of treatment. H. pylori eradication did not accelerate the improvement of hemoglobin concentrations in the overall analysis (MD, 0.38 g/dl; 95%CI, -0.45 to 1.22; P = 0.37). In a subgroup analysis, H. pylori eradication did not accelerate the improvement of hemoglobin concentrations one month (MD, -0.48 g/dl; 95%CI, -2.39 to 1.42; P = 0.62), three months (MD, -0.10 g/dl; 95%CI, -0.35 to 0.15; P = 0.44) and forty months (MD, 0.10 g/dl; 95%CI, -0.37 to 0.57; P = 0.68) after the initiation of treatment. However, H. pylori eradication accelerated the improvement of hemoglobin concentrations two months (MD, 1.96 g/dl; 95%CI, 1.48 to 2.44; P < 0.00001) and one year (MD, 0.37 g/dl; 95%CI, 0.08 to 0.65; P = 0.01) after the initiation of treatment.


CONCLUSIONS
H. pylori eradication is likely to improve the absorption of oral ferrous. H. pylori infection may play some roles in the development of ID.
Zhang
Zhi-Feng
ZF
Department of Gastroenterology, First Affiliated Hospital of Dalian Medical University, Dalian Medical University, Dalian, Liaoning 116011, China.
Yang
Ning
N
Zhao
Gang
G
Zhu
Lei
L
Zhu
Ying
Y
Wang
Li-Xia
LX
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D000900:Anti-Bacterial Agents