幽门螺杆菌与非酒精性脂肪性肝病关系的Meta分析  

Association between Helicobacter pylori and nonalcoholic fatty liver disease:A Meta-analysis

作　　者：喻余珍 邱烈旺[1] 何平[1] YU Yuzhen;QIU Liewang;HE Ping(Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院,重庆402160

出　　处：《临床肝胆病杂志》2024年第7期1360-1369,共10页Journal of Clinical Hepatology

摘　　要：目的 探讨幽门螺杆菌(HP)感染与非酒精性脂肪性肝病(NAFLD)二者的关系。方法 本研究根据PRISMA指南完成,PROSPERO注册号:CRD42023408932。检索Pub Med、Cochrane Library、Web of Science、Embase、CBM、万方、中国知网、维普等数据库成立截至2023年6月的相关文献。选择纳入有明确HP检测标准及NAFLD评估标准,与此同时采用多因素分析评估二者相关性的病例对照研究、横断面研究及队列研究。选择优势比(OR)及其95%CI作为效应量,采用STATA 15.0软件进行Meta分析。结果 共纳入33项原始研究,包含236 514例受试者。Meta分析结果提示,HP与NAFLD高患病率相关(OR=1.25,95%CI:1.16~1.35,P<0.05,I2=93.7%),在样本量、HP诊断方式、原始研究质量、受试者健康状况、原始研究类型方面分别行亚组分析,未找到明确的异质性来源。以样本量、HP诊断方式、原始研究质量、受试者健康状况、原始研究类型为协变量行Meta回归分析,结果提示受试者健康状况、原始研究类型可能为异质性来源。敏感性分析提示总体结果稳定,漏斗图及Egger检验未提示明显发表偏倚。结论 在总体人群中,HP与NAFLD高患病率相关,仍需要大规模的前瞻性队列研究具体和全面地评价HP与NAFLD之间的相关性。Objective To investigate the association between Helicobacter pylori infection and nonalcoholic fatty liver disease(NAFLD).Methods This study was conducted acoording to the PRISMA guideline,with a PROSPERO registration number of CRD42023408932.Databases including PubMed,the Cochrane Library,Web of Science,Embase,CBM,Wanfang Data,CNKI,and VIP were searched for related articles published up to June 2023.This study was conducted for the case-control studies,cross-sectional studies,and cohort studies that included clear detection criteria for HP and evaluation criteria for NAFLD and performed the multivariate analysis to investigate the association between HP infection and NAFLD.Odds ratio(OR)and its 95%confidence interval(CI)were selected as the effect measures,and STATA 15.0 software was used to perform the Meta-analysis.Results A total of 33 primary studies were included,with 236514 subjects in total.The Meta-analysis showed that HP was associated with the high prevalence rate of NAFLD(OR=1.25,95%CI:1.16—1.35,P<0.05,I2=93.7%).Subgroup analysis was conducted in terms of sample size,the diagnostic method for HP,the quality of primary study,the health status of subjects,and the type of primary study,but no clear source of heterogeneity was found.The Meta-regression analysis was conducted with the covariates of sample size,the diagnostic method for HP,the quality of primary study,the health status of subjects,and the type of primary study,and the results showed that the health status of subjects and the type of primary study might be the sources of heterogeneity.Sensitivity analysis showed that the overall results were stable,and funnel plots and the Egger test showed no significant publication bias.Conclusion HP is associated with the high prevalence rate of NAFLD in the general population,and large-scale prospective cohort studies are still needed to specifically and comprehensively evaluate the association between HP and NAFLD.

关 键 词：幽门螺杆菌 非酒精性脂肪性肝病 META分析 

分 类 号：R575.5[医药卫生—消化系统]