Helicobacter pylori infection and circulating ghrelin levels - a systematic review.
BACKGROUND
The nature of the association between ghrelin, an orexigenic hormone produced mainly in the stomach, and Helicobacter pylori (H pylori), a bacterium that colonises the stomach, is still controversial. We examined available evidence to determine whether an association exists between the two; and if one exists, in what direction.


METHODS
We reviewed original English language studies on humans reporting circulating ghrelin levels in H pylori infected and un-infected participants; and circulating ghrelin levels before and after H pylori eradication. Meta-analyses were conducted for eligible studies by combining study specific estimates using the inverse variance method with weighted average for continuous outcomes in a random effects model.


RESULTS
Seventeen out of 27 papers that reported ghrelin levels in H pylori positive and negative subjects found lower circulating ghrelin levels in H pylori positive subjects; while 10 found no difference. A meta-analysis of 19 studies with a total of 1801 participants showed a significantly higher circulating ghrelin concentration in H pylori negative participants than in H pylori positive participants (Effect estimate (95%CI) = -0.48 (-0.60, -0.36)). However, eradicating H pylori did not have any significant effect on circulating ghrelin levels (Effect estimate (95% CI) = 0.08 (-0.33, 0.16); Test for overall effect: Z = 0.67 (P = 0.5)).


CONCLUSIONS
We conclude that circulating ghrelin levels are lower in H pylori infected people compared to those not infected; but the relationship between circulating ghrelin and eradication of H pylori is more complex.
Nutrition Programme, Medical Research Council Laboratories, The Gambia, PO Box 273, Banjul, The Gambia. cnweneka@mrc.gm
Chidi V
CV
Nweneka
Andrew M
AM
Prentice
D005753:Gastric Mucosa / Q000378:metabolism*; D054439:Ghrelin / Q000097:blood*; D016481:Helicobacter Infections / Q000097:blood* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D013270:Stomach / Q000382:microbiology
D054439:Ghrelin
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