title: Helicobacter pylori and Risk of Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis.
abstract: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection. Patients with H. pylori infection may be at an increased risk of nonalcoholic fatty liver disease (NAFLD) because of chronic inflammation and insulin resistance. Several epidemiologic studies attempting to determine this risk have yielded inconsistent results. This meta-analysis was conducted with the aims to summarize all available evidence and estimate the risk of NAFLD in patients with H. pylori infection.
  
  
  
  A literature search was performed using MEDLINE and EMBASE database from inception to June 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of NAFLD among patients with H. pylori infection versus without H. pylori infection were included. Pooled odds ratios and 95% confidence intervals were calculated using a random-effect, generic inverse variance method.
  
  
  
  Six studies met our eligibility criteria and were included in this analysis. We found a statistically significant increased risk of NAFLD among patients with H. pylori infection with the pooled odds ratios of 1.21 (95% confidence interval, 1.07-1.37). The statistical heterogeneity was low with an I of 49%.
  
  
  
  A significantly increased risk of NAFLD among patients with H. pylori infection was demonstrated in this meta-analysis. Further studies are required to clarify how this risk should be addressed in clinical practice.
authors.affiliation: Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY.
authors.forename: Karn
authors.initials: K
authors.lastname: Wijarnpreecha
authors.affiliation: Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY.
authors.forename: Charat
authors.initials: C
authors.lastname: Thongprayoon
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Panadeekarn
authors.initials: P
authors.lastname: Panjawatanan
authors.affiliation: Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Wuttiporn
authors.initials: W
authors.lastname: Manatsathit
authors.affiliation: Department of Internal Medicine, University of Hawaii, Honolulu, HI.
authors.forename: Veeravich
authors.initials: V
authors.lastname: Jaruvongvanich
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Rochester, MN.|Department of Medicine, Division of Rheumatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok.
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
mesh_terms: D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D007333:Insulin Resistance; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D012307:Risk Factors