Relationship between Helicobacter pylori infection and osteoporosis: a systematic review and meta-analysis

• Published in: BMJ open Vol. 9; no. 6; p. e027356
• Main Authors: Wang, Taiwu, Li, Xiang, Zhang, Qi, Ge, Bingjie, Zhang, Jinhai, Yu, Lei, Cai, Tongjian, Zhang, Yao, Xiong, Hongyan
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.06.2019; BMJ Publishing Group
• Subjects: Bacterial infections; Bone density; Campylobacter; Cytokines; Epidemiology; Evidence-based medicine; Fractures; Gastroenterology; Gastrointestinal diseases; Liver diseases; Meta-analysis; Osteoporosis; Quality; Systematic review; TNF inhibitors; Tumor necrosis factor-TNF; Womens health; helicobacter pylori; meta-analysis; bone mineral density; osteoporosis
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-027356

ObjectivesMany studies have explored the association between Helicobacter pylori infection and osteoporosis. However, the results remain controversial. Therefore, we performed this systematic review and meta-analysis to evaluate the association between H. pylori infection and osteoporosis.DesignSystematic review and meta-analysis of case–control studies.Data sourcesDatabases, including PubMed, Embase, Web of Science and Chinese Biomedical Literature Database, were screened from inception to 30 April 2018.Eligibility criteriaCase–control studies aimed at assessing the association between H. pylori infection and osteoporosis.Data extraction and analysisStudy characteristics and study quality sections were reviewed. Studies were selected, and data were extracted by two reviewers. Pooled ORs and 95% CIs were calculated using random effects model if heterogeneity existed; otherwise, fixed effects model was used. Subgroup analyses were performed to explore the source of heterogeneity. Publication bias and sensitivity analyses were also tested.ResultsA total of 21 studies with 9655 participants were included in our analyses. Taking together, we found that H. pylori infection was associated with increased odds of osteoporosis (OR (95% CI): 1.39 (1.13 to 1.71)); there was no significant difference between osteoporosis and osteopaenia; the association between osteoporosis and H. pylori infection was relatively higher in men than women but did not reach significant level. However, the decrease of bone mineral density in H. pylori-positive patients was not significant when compared with H. pylori negative controls, which may due to the sample size.ConclusionsOur meta-analysis suggests an association between osteoporosis and H. pylori infection. The clinicians should pay more attention to the patients infected with H. pylori. Further studies were still needed to exploring the confounding factors among studies and to elucidate the underlying biological mechanisms.