Association between Helicobacter pylori infection and metabolic syndrome: a systematic review and meta-analysis.
OBJECTIVE
To systematically review and quantify the effect of Helicobacter pylori (H. pylori) infection on the risk of metabolic syndrome (MS) and metabolic parameters in individuals with H. pylori infection.


METHODS
A systematic search of MEDLINE and EMBASE was performed. Inclusion criteria were observational studies assessing the association between H. pylori infection and MS in adult participants. We calculated the pooled effect estimate of MS with 95% confidence interval (CI) between patients infected with H. pylori and those without by using a random-effects model. The secondary outcomes were the differences between groups in homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride, high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), body mass index (BMI) and systolic blood pressure (SBP).


RESULTS
Altogether 18 trials with 27 544 participants met the inclusion criteria. Six trials were included in the analysis of MS. There was a statistically significant association between H. pylori and MS with a pooled odds ratio of 1.34 (95% CI 1.17-1.53, I(2)  = 39%, Pheterogeneity < 0.01). Between the infected and non-infected groups there were significant differences in FBG, HDL-C, BMI, triglyceride, HOMA-IR and SBP (all P < 0.05).


CONCLUSIONS
H. pylori infection is positively associated with MS. Infection with H. pylori is also associated with higher triglyceride, FBG, BMI, HOMA-IR, SBP and lower HDL-C.
Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York, USA.|Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sikarin
S
Upala
Department of Internal Medicine, University of Hawaii, Honolulu, Hawaii, USA. jaruvong@hawaii.edu.|Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. jaruvong@hawaii.edu.
Veeravich
V
Jaruvongvanich
Department of Internal Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Tanawan
T
Riangwiwat
Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Suthinee
S
Jaruvongvanich
Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York, USA.|Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Anawin
A
Sanguankeo
D016481:Helicobacter Infections / Q000150:complications* / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000382:microbiology* / Q000503:physiopathology; D017594:Publication Bias
Campylobacter infection; Helicobacter pylori; insulin resistance; meta-analysis; metabolic syndrome