Helicobacter pyloriInfection and Anemia in Taiwanese Adults

Abstract

Background. Chronic Helicobacter pylori infection and iron-deficiency anemia (IDA) are common in adults. Although the most common causes of IDA usually arise from the gastrointestinal tract, the association between chronic Helicobacter pylori infection and anemia remains unclear. Aim. To evaluate the association of chronic Helicobacter pylori infection and IDA. Materials and Methods. We enrolled 882 patients from January 2010 to April 2013. The status of Helicobacter pylori (H.p) infection was confirmed and blood samples from the same participants were taken on the same day to check the level of hemoglobin, serum iron, ferritin, and total iron-binding capacity (TIBC). Results. No significant difference was noted from the demographic data. The average level of hemoglobin (Hb) was not different between negative and positive groups, pos 13.57 g/dL versus neg 13.65 g/dL (P = 0.699). Although the levels of serum IDA related parameters were expected in positive group (lower serum iron and ferritin and higher TIBC) these differences did not reach statistical significance (P = 0.824 for iron, P = 0.360 for ferritin, and P = 0.252 for TIBC). Conclusion. Chronic Helicobacter pylori infection is not attributed to IDA. The levels of hemoglobin, serum iron and ferritin, and TIBC remain unaffected after chronic H.p infection. Large-scale clinical studies are needed to prove the association.

An updated systematic review and meta‐analysis on the association between Helicobacter pylori infection and iron deficiency anemia

“…A stronger positive association between H. pylori infection and ID was found in a subgroup analysis of studies that adjusted for confounders (OR 1.41, 95% CI 1.17–1.71), Pv<.001. Separate meta‐analyses of pediatric and adult studies that adjusted for confounders showed similar results (OR 1.43, 95% CI 1.15–1.78) and (OR 1.37, 95% CI 1.01–1.86), respectively, while such association was nonsignificant (OR 1.21, 95% CI 0.94–1.56; Pv=.13) in a meta‐analysis of unadjusted results …”

“…The 44 studies that scored 12 points or less in the quality assessment score were therefore excluded from the meta‐analysis. Fifty observational studies addressed the outcomes IDA, ID, and/or anemia and met inclusion criteria (Table ) . These studies varied in their design, study population, and method of detecting H. pylori infection; in their classification of IDA, ID, and/or anemia; and in their findings (Table ).…”

“…Eleven cross‐sectional studies and three case–control studies addressed IDA as an outcome. Seven studies enrolled children and adolescents; one study included both children and adults, in which age‐adjusted results were presented; and the rest were conducted among adults only . Results of the meta‐analysis showed a significantly increased likelihood of IDA in individuals with evidence of H. pylori infection compared to uninfected persons, pooled OR 1.72 (95% CI 1.23–2.42) Pv<.001 (Fig.…”

“…A combined analysis of 30 studies that addressed the association between H. pylori infection and ID showed an increased likelihood of ID among H. pylori ‐infected vs uninfected individuals, pooled OR 1.33 (95% CI 1.15–1.54) Pv<.001. Significant heterogeneity was noted among the studies: χ 2 =49.25, df =29, Pv=.01, I 2 =41.1%, which was reduced (χ 2 =36.5, df =26, Pv=.08, I 2 =28.7%) after excluding three studies, without changing the combined point estimate, OR 1.35 (95% CI 1.18–1.55) Pv<.001.…”

Helicobacter pylori and Extragastric Diseases

“… did not find any significant association between H. pylori infection and serum levels of prohepcidin, while this biomarker was decreased in patients with atrophic gastritis. Finally, the results of three recent studies did not support any association between H. pylori infection and IDA ; however, the occurrence of some biases, such as the exact definition of IDA or the absence of information concerning the specific gastric histologic patterns shown by patients, may, in our opinion, affect the results of studies performed on this important issue.…”