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Epidemiology
Research
Relationship between Helicobacter pylori infection and osteoporosis: a systematic review and meta-analysis
  1. Taiwu Wang1,2,
  2. Xiang Li3,
  3. Qi Zhang2,
  4. Bingjie Ge4,
  5. Jinhai Zhang2,
  6. Lei Yu1,
  7. Tongjian Cai1,
  8. Yao Zhang1,
  9. Hongyan Xiong1
  1. 1 Department of Epidemiology, Third Military Medical University, Chongqing, China
  2. 2 Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, China
  3. 3 School of Pharmacy, The Southwest Medical University, Luzhou, China
  4. 4 95810 Unit, The Chinese People’s Liberation Army, Beijing, China
  1. Correspondence to Dr Yao Zhang; sydzy2003{at}sina.com and Prof Hongyan Xiong; hongyanxiong{at}126.com

Abstract

Objectives Many 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.

Design Systematic review and meta-analysis of case–control studies.

Data sources Databases, including PubMed, Embase, Web of Science and Chinese Biomedical Literature Database, were screened from inception to 30 April 2018.

Eligibility criteria Case–control studies aimed at assessing the association between H. pylori infection and osteoporosis.

Data extraction and analysis 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.

Results A 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.

Conclusions Our 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.

  • osteoporosis
  • bone mineral density
  • helicobacter pylori
  • meta-analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-027356

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    Footnotes

    • TW and XL contributed equally.

    • Contributors YZ and HX led the study by designing, interpreting results and revising manuscript critically for important intellectual content, jointly supervised this work; TW and XL contributed to data analysis, result interpretation and drafting of the manuscript; QZ, BG and JZ participated in study data collection and revising manuscript; TW, XL, TC and LY participated in study conduct and results interpretation. All authors read and approved the final manuscript.

    • Funding This work was supported by the National Natural Science Foundation of China (No. 81202220 to YZ; No. 81673211 and 81372952 to TC), by the Natural Science Foundation of Jiangsu Province, China (No. BK20150094 to QZ) and by the Chongqing Health and Family Planning Commission (No. 20141027 to HX).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Patient consent for publication Not required.