Effects of Helicobacter pylori eradication on insulin resistance and metabolic parameters: a systematic review and meta-analysis.
BACKGROUND
Previous studies have shown a close relationship between Helicobacter pylori (H. pylori), insulin resistance, and altered metabolic parameters. However, the effects of H. pylori eradication on these conditions remain controversial. We carried out a systematic review and meta-analysis to evaluate the effects of H. pylori eradication on insulin resistance and metabolic parameters.


METHODS
We searched CENTRAL, MEDLINE, and EMBASE databases from their inception to July 2016. Insulin resistance (HOMA-IR), body weight (BW), BMI, waist circumference, triglycerides (TG), high-density and low-density lipoprotein-cholesterol (HDL-C and LDL-C), and fasting blood glucose (FBG) were compared between patients with and without H. pylori eradication using a random-effects model. We reported pooled mean differences (MD) and 95% confidence intervals (CI) for the change in outcomes.


RESULTS
Data from five studies showed no difference in HOMA-IR after H. pylori eradication (pooled MD=-0.52, 95% CI: -1.47 to 0.42). Eradication significantly increased BMI (MD=0.36, 95% CI: 0.11-0.60) and BW (MD=1.1, 95% CI: 0.8-1.5), but had no significant effects on TG, LDL-C, HDL-C, or FBG.


CONCLUSIONS
H. pylori eradication does not improve insulin resistance, TG, HDL-C, LDL-C, or FBG, but may increase BW and BMI. Further studies are needed to clarify the effect of H. pylori eradication on metabolism.
aDepartment of Internal Medicine, Bassett Medical Center, Columbia University College of Physicians and Surgeons, Cooperstown, New York bDepartment of Internal Medicine, University of Hawaii, Honolulu, Hawaii, USA cDepartment of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Salaya dDepartment of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Sikarin
S
Upala
Anawin
A
Sanguankeo
Sheikh A
SA
Saleem
Veeravich
V
Jaruvongvanich
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000378:metabolism; D016480:Helicobacter pylori; D006801:Humans; D007333:Insulin Resistance; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D055105:Waist Circumference
D000900:Anti-Bacterial Agents; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D054328:Proton Pump Inhibitors; D014280:Triglycerides