Relationship betweenHelicobacter pyloriinfection and osteoporosis: a systematic review and meta-analysis

Abstract

ObjectivesMany studies have explored the association betweenHelicobacter pyloriinfection and osteoporosis. However, the results remain controversial. Therefore, we performed this systematic review and meta-analysis to evaluate the association betweenH. pyloriinfection 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 betweenH. pyloriinfection 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 thatH. pyloriinfection 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 andH. pyloriinfection was relatively higher in men than women but did not reach significant level. However, the decrease of bone mineral density inH. pylori-positive patients was not significant when compared withH. pylorinegative controls, which may due to the sample size.ConclusionsOur meta-analysis suggests an association between osteoporosis andH. pyloriinfection. The clinicians should pay more attention to the patients infected withH. pylori. Further studies were still needed to exploring the confounding factors among studies and to elucidate the underlying biological mechanisms.

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

“…Most studies were retrospective, single-center, cross-sectional, non-randomized ( Table 1 ). Two recent meta-analyses came to opposite conclusions [ 12 , 14 ]. The first analysis [ 12 ], which included five studies involving 1321 participants (1068 women), found no significant association between HPI and OP (pooled OR 1.49, 95% CI 0.88–2.55, p = 0.14).…”

“…The first analysis [ 12 ], which included five studies involving 1321 participants (1068 women), found no significant association between HPI and OP (pooled OR 1.49, 95% CI 0.88–2.55, p = 0.14). In the second report [ 14 ], based on 21 observational studies with 9655 participants, HPI was significantly associated with OP (OR 1.39, 95% CI 1.13–1.71, p < 0.001). The results of these two meta-analyses should be interpreted cautiously in light of heterogeneity (stated by the authors of both reports) and obvious limitations: no information on H.p.…”

“…A possible association between HPI and over 50 systemic diseases has been described. In recent years numerous reviews focused on this topic [ 11 , 13 , 14 , 68 , 79 , 331 , 332 , 333 , 334 , 335 , 336 , 337 , 338 , 339 , 340 , 341 , 342 , 343 , 344 , 345 , 346 ]. Most of HPI–linked extra-gastroduodenal chronic diseases and disorders as well as treatments used for are known to increase risk of OP, falls and OFs, especially in the elderly [ 317 , 347 , 348 , 349 ].…”

“…colonizes the human stomach in over 50% of the world’s population [ 8 , 9 , 10 , 11 ] and HPI frequently coexists with OP/OF, deeper understanding the relationships among HPI-related diseases, the skeleton and falls becomes highly important; it may help to improve the preventive and therapeutic strategies for OFs. However, only a small number of studies have examined the association between HPI and bone status and the results have been controversial [ 12 , 13 , 14 ]. Although conventional wisdom suggests that in clinical practice the two main components of OFs—OP and falls—need to be integrated and viewed under complementary angles, the possible contribution of HPI-associated diseases to falls has not been addressed in the literature systematically.…”

Vitamin D3 Inhibits Helicobacter pylori Infection by Activating the VitD3/VDR-CAMP Pathway in Mice

“…In vitro studies have revealed that VitD3 application can inhibit virulence factor expression in Porphyromonas gingivalis and halt bacterial growth (Grenier et al, 2016). Clinically, individuals with osteoporosis have a higher H. pylori infection rate, and those receiving early preventive treatment with VitD3 replenishment have a lower rate of H. pylori infection (Chinda et al, 2019;Wang et al, 2019). In addition, the long-term use of 1 a-hydroxyvitamin D 3 (an analog of VitD3) has been shown to reduce the risk of H. pylori infection (Kawaura et al, 2006).…”