The Effect of Helicobacter pylori Eradication on Lipid Levels: A Meta-Analysis

Abstract

Introduction: Helicobacter pylori (H. pylori) infection is positively associated with cardiovascular diseases, but the involvement of lipids in this association remains unclear. The present study reviewed the changes in circulating lipid levels following H. pylori eradication. Methods: A PubMed database was searched until December 2020 to identify randomized control trials (RCTs) and non-RCTs investigating the effect of H. pylori eradication on the lipid levels in inverse variance-weighted, random-effects meta-analyses. Results: A total of 24 studies (four RCTs and 20 non-RCTs) with 5270 participants were identified. The post-eradication levels were increased for high-density lipoprotein cholesterol (HDL-C; mean difference (MD) 2.28 mg/dL, 95% confidence interval (CI) 1.90 to 2.66) and triglyceride (TG; MD 3.22 mg/dL, 95% CI 1.13 to 5.31) compared with the pre-eradication levels. H. pylori eradication resulted in little to no difference in the low-density lipoprotein-cholesterol levels (MD −2.33 mg/dL, 95% CI −4.92 to 0.26). In the analyses of RCTs only, the findings for elevated HDL-C levels, but not TG, were robust. Conclusions: H. pylori eradication increases the HDL-C levels. Further studies are needed to elucidate the effects of lipid changes following H. pylori eradication on cardiovascular diseases.

No evidence for a causal link between Helicobacter pylori infection and nonalcoholic fatty liver disease: A bidirectional Mendelian randomization study

“…However, the results are controversial. Several studies reported that no significant differences in serum lipid levels were found between the H. pylori positive group and the H. pylori negative group, and the lipid levels also did not change significantly following H. pylori eradication ( Elizalde et al, 2002 ; Akbas et al, 2010 ; Watanabe et al, 2021 ). This is probably due to differences in the general characteristics of the study populations and the lack of control for confounding factors related to lipid profiles.…”

Long-term Effects of the Eradication of Helicobacter pylori on Metabolic Parameters, Depending on Sex, in South Korea

“…A recent meta-analysis of 24 studies with 5,270 participants, including four randomized controlled trials and 20 non-randomized controlled trials, showed an increase in HDL and TG levels after eradication and in the subgroup analysis of only randomized controlled trials, HDL elevation, but not TG, remained significant. 21 However, among the 24 studies, only two had follow-up periods of longer than a year. Meanwhile, in a study of 496 patients with HP-positive dyspepsia and/or peptic ulcer in Italy in 2009, Pellicano et al 24 reported that HDL, BMI, and DBP increased significantly at 5 years after HP eradication compared to baseline.…”

“…[15][16][17][18] However, the effect of HP eradication on MS remains controversial, despite a number of emerging studies. Several investigations have reported that eradication decreases the risk of dyslipidemia 19 or improved MS. [20][21][22] However, other studies have reported conflicting results. A recent study conducted in Taiwan showed improvements in metabolic parameters, with a decrease in insulin resistance, triglycerides (TGs), and low-density lipoprotein (LDL) and an increase in high-density lipoprotein (HDL), but no significant change in the prevalence of MS after eradication.…”

Helicobacter pylori-Related Extraintestinal Manifestations—Myth or Reality

“…Furthermore, obesity was not proven to enhance insulin resistance in the setting of H. pylori infection, it being stated that H. pylori is in fact responsible for adverse lipid profile outcomes [ 92 ]. In terms of lipid profile parameters, H. pylori eradication was proven to increase the high-density lipoprotein levels [ 166 ] ( Table 2 ). However, it was emphasized that the H. pylori eradication rate is lower in obese patients when compared to controls [ 80 ].…”