title: The association between Helicobacter pylori infection and insulin resistance: a systematic review.
abstract: BACKGROUND
  Helicobacter pylori infection has been associated with diverse extradigestive morbidity, including insulin resistance (IR) syndrome. The aim of this systematic review was to summarize the epidemiologic evidence concerning the association between H. pylori infection and IR quantitative indexes.
  
  
  METHODS
  A computerized literature search in PubMed electronic databases and Cochrane Central Register of Controlled Trials was performed.
  
  
  RESULTS
  Nine studies reporting data on 2120 participants were finally eligible for this systematic review. Seven of them were cross-sectional studies and two were nonrandomized, open-label, controlled trials investigating the effect of H. pylori eradication on IR. Homeostatic model of assessment insulin resistance (HOMA-IR) was used in all studies to quantify IR. There seems to be a trend toward a positive association between H. pylori infection and HOMA-IR, strengthened by regression analysis in one study. However, there was significant heterogeneity between studies regarding the method(s) of H. pylori infection diagnosis based on and the study populations. The studies for the effect of H. pylori eradication on HOMA-IR revealed conflicting results.
  
  
  CONCLUSIONS
  Although data seem to indicate a potential association between H. pylori infection and IR, further studies are needed to strengthen this association and to clarify whether there is a causative link between them. If a causal link is confirmed in the future, this may have a major impact on the pathophysiology and management of IR syndrome, including type 2 diabetes mellitus and nonalcoholic fatty liver disease.
authors: Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece.
authors: Stergios A
authors: SA
authors: Polyzos
authors: Jannis
authors: J
authors: Kountouras
authors: Christos
authors: C
authors: Zavos
authors: Georgia
authors: G
authors: Deretzi
mesh_terms: D000328:Adult; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000382:microbiology; D008875:Middle Aged; D055815:Young Adult