The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis

Background. The association between Helicobacter pylori infection and glycated hemoglobin A has been confirmed in many studies, but these conclusions are still contradictory and controversial. Therefore, we conducted a meta-analysis to resolve the problem of inconsistent results in diabetes. Methods...

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Main Authors: Jinhu Chen, Yuling Xing, Liying Zhao, Huijuan Ma
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2019/3705264
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author Jinhu Chen
Yuling Xing
Liying Zhao
Huijuan Ma
author_facet Jinhu Chen
Yuling Xing
Liying Zhao
Huijuan Ma
author_sort Jinhu Chen
collection DOAJ
description Background. The association between Helicobacter pylori infection and glycated hemoglobin A has been confirmed in many studies, but these conclusions are still contradictory and controversial. Therefore, we conducted a meta-analysis to resolve the problem of inconsistent results in diabetes. Methods. A comprehensive search was conducted on related researches published in PubMed, Embase, and China Academic Journal Full-text Database (CNKI) from the inception of each database to April 2019. Fixed or random effects model was used to pool the weighted mean difference with 95% confidence interval from individual studies. Subgroup and sensitivity analyses were also performed. Publication bias was estimated by funnel plot, Egger’s test, and fail-safe numbers. Results. 35 studies with 4,401 participants with diabetes were included in the meta-analysis. Glycated hemoglobin A levels were elevated in patients with Helicobacter pylori infection compared with patients without Helicobacter pylori infection (WMD=0.50, 95% CI: 0.28-0.72, p<0.001). In subgroup analysis by the subtype of diabetes, there was a correlation between Helicobacter pylori infection and elevated glycated hemoglobin A in type 1 diabetes (I2=74%, p<0.001, WMD=0.46, 95% CI: 0.12-0.80), and in type 2 diabetes (I2=90%, p<0.001, WMD=0.59, 95% CI: 0.28-0.90, p<0.001). In subgroup analysis by the study design, there was a correlation in cross-sectional study (I2=89%, p<0.001, WMD=0.42, 95% CI: 0.16-0.69, p≤0.003) and in case-control study (I2=83%, p<0.001, WMD=0.39, 95% CI: 0.14-0.64, p≤0.003). By different methods for detecting Helicobacter pylori, there was a correlation in the biopsy group (I2=83%, p<0.001, WMD=0.6, 95% CI: 0.11-1.09, p≤0.03) and in other groups of test methods (I2=87%, p<0.001, WMD=0.37, 95% CI: 0.17-0.56, p<0.001). Sensitivity analysis showed that our results were reliable, and no evidence of substantial publication bias was detected. Conclusion. The meta-analysis might indicate a correlation between Helicobacter pylori infection and glycated hemoglobin A levels in diabetes.
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spelling doaj-art-69062d4d173942f09d8ae3dab6a258762025-08-20T02:35:25ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/37052643705264The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-AnalysisJinhu Chen0Yuling Xing1Liying Zhao2Huijuan Ma3Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, ChinaGraduate School of Hebei Medical University, Shijiazhuang 050017, ChinaGraduate School of Hebei Medical University, Shijiazhuang 050017, ChinaDepartment of Endocrinology, Hebei General Hospital, Shijiazhuang 050017, ChinaBackground. The association between Helicobacter pylori infection and glycated hemoglobin A has been confirmed in many studies, but these conclusions are still contradictory and controversial. Therefore, we conducted a meta-analysis to resolve the problem of inconsistent results in diabetes. Methods. A comprehensive search was conducted on related researches published in PubMed, Embase, and China Academic Journal Full-text Database (CNKI) from the inception of each database to April 2019. Fixed or random effects model was used to pool the weighted mean difference with 95% confidence interval from individual studies. Subgroup and sensitivity analyses were also performed. Publication bias was estimated by funnel plot, Egger’s test, and fail-safe numbers. Results. 35 studies with 4,401 participants with diabetes were included in the meta-analysis. Glycated hemoglobin A levels were elevated in patients with Helicobacter pylori infection compared with patients without Helicobacter pylori infection (WMD=0.50, 95% CI: 0.28-0.72, p<0.001). In subgroup analysis by the subtype of diabetes, there was a correlation between Helicobacter pylori infection and elevated glycated hemoglobin A in type 1 diabetes (I2=74%, p<0.001, WMD=0.46, 95% CI: 0.12-0.80), and in type 2 diabetes (I2=90%, p<0.001, WMD=0.59, 95% CI: 0.28-0.90, p<0.001). In subgroup analysis by the study design, there was a correlation in cross-sectional study (I2=89%, p<0.001, WMD=0.42, 95% CI: 0.16-0.69, p≤0.003) and in case-control study (I2=83%, p<0.001, WMD=0.39, 95% CI: 0.14-0.64, p≤0.003). By different methods for detecting Helicobacter pylori, there was a correlation in the biopsy group (I2=83%, p<0.001, WMD=0.6, 95% CI: 0.11-1.09, p≤0.03) and in other groups of test methods (I2=87%, p<0.001, WMD=0.37, 95% CI: 0.17-0.56, p<0.001). Sensitivity analysis showed that our results were reliable, and no evidence of substantial publication bias was detected. Conclusion. The meta-analysis might indicate a correlation between Helicobacter pylori infection and glycated hemoglobin A levels in diabetes.http://dx.doi.org/10.1155/2019/3705264
spellingShingle Jinhu Chen
Yuling Xing
Liying Zhao
Huijuan Ma
The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
Journal of Diabetes Research
title The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
title_full The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
title_fullStr The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
title_full_unstemmed The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
title_short The Association between Helicobacter pylori Infection and Glycated Hemoglobin A in Diabetes: A Meta-Analysis
title_sort association between helicobacter pylori infection and glycated hemoglobin a in diabetes a meta analysis
url http://dx.doi.org/10.1155/2019/3705264
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