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Effects of Helicobacter pylori eradication on insulin resistance and metabolic parameters: a systematic review and meta-analysis

Upala, Sikarin; Sanguankeo, Anawin; Saleem, Sheikh A.; Jaruvongvanich, Veeravich

European Journal of Gastroenterology & Hepatology: February 2017 - Volume 29 - Issue 2 - p 153–159
doi: 10.1097/MEG.0000000000000774
Original Articles: Gastro-oesophageal Disorders

Introduction: 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.

Conclusion: 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

Correspondence to Veeravich Jaruvongvanich, MD, Department of Internal Medicine, University of Hawaii, 1511 Nuuanu Ave, Honolulu, Hawaii 96817, USA Tel: +1 808 542 1939; fax: +1 808 586 7486; e-mail: veeravich_j@hotmail.com

Received July 16, 2016

Accepted September 15, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.