Relationship between <i>Helicobacter pylori</i> infection and osteoporosis: a systematic review and meta-analysis.

Abstract

Many studies have explored the association between <i>Helicobacter pylori</i> infection and osteoporosis. However, the results remain controversial. Therefore, we performed this systematic review and meta-analysis to evaluate the association between <i>H. pylori</i> infection and osteoporosis. Systematic review and meta-analysis of case-control studies. Databases, including PubMed, Embase, Web of Science and Chinese Biomedical Literature Database, were screened from inception to 30 April 2018. Case-control studies aimed at assessing the association between <i>H. pylori</i> infection and osteoporosis. Study 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. A total of 21 studies with 9655 participants were included in our analyses. Taking together, we found that <i>H. pylori</i> 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 <i>H. pylori</i> infection was relatively higher in men than women but did not reach significant level. However, the decrease of bone mineral density in <i>H. pylori</i>-positive patients was not significant when compared with <i>H. pylori</i> negative controls, which may due to the sample size. Our meta-analysis suggests an association between osteoporosis and <i>H. pylori</i> infection. The clinicians should pay more attention to the patients infected with <i>H. pylori</i>. Further studies were still needed to exploring the confounding factors among studies and to elucidate the underlying biological mechanisms.