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Song X, Cai C, Jin Q, Chen X, Yu C. The efficacy of Helicobacter pylori eradication in diabetics and its effect on glycemic control: A systematic review and meta-analysis. Helicobacter 2021; 26:e12781. [PMID: 33465265 DOI: 10.1111/hel.12781] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS Previous studies have revealed the association between Helicobacter pylori (H. pylori) and diabetes mellitus, but conflicts still exist. The present study tried to investigate the underlying link between these two diseases by making comprehensive analyses of the impact of diabetes on H. pylori eradication and the influence of H. pylori eradication on diabetes. METHODS We systematically searched relevant studies from PubMed, Cochrane Library, Web of Science, and Embase updated to April 23, 2020. Studies examining the association between H. pylori eradication and diabetes were included. Pooled odds ratio (OR) and weighted mean differences (WMD) were calculated for different results. RESULTS Among the 2125 retrieved studies, 36 studies were included. Patients with type 2 diabetes mellitus (T2DM) have higher risk of H. pylori eradication failure than the non-diabetic one (OR = 2.59, 95% CI 1.82-3.70). Body mass index (BMI) was identified as a major factor affecting the efficacy of H. pylori eradication in diabetics, and better glycemic control was also found in eradication succeed patients (WMD: 0.51, 95% CI 0.20-0.81). Moreover, after eradication of H. pylori, improvement of HbA1c was proved (WMD = -0.33, 95% CI -0.65 to -0.02) in T2DM. CONCLUSION A higher risk of H. pylori eradication failure in T2DM was confirmed, and it was associated with BMI and glycemic control. Moreover, we also provided evidence that H. pylori eradication could improve glycemic control in patients with T2DM, which indirectly reflect the interaction between H. pylori and the diabetes.
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Affiliation(s)
- Xin Song
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Changzhou Cai
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qi Jin
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xueyang Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chaohui Yu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Yang YJ, Wu CT, Ou HY, Lin CH, Cheng HC, Chang WL, Chen WY, Yang HB, Lu CC, Sheu BS. Ten days of levofloxacin-containing concomitant therapy can achieve effective Helicobacter pylori eradication in patients with type 2 diabetes. Ann Med 2017; 49:479-486. [PMID: 28266875 DOI: 10.1080/07853890.2017.1294761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study investigated whether levofloxacin-containing concomitant therapy can effectively eradicate Helicobacter pylori infection in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 797 T2DM patients were screened for anti-H. pylori IgG antibodies, and the presence of H. pylori infection was confirmed by 13C-urea breath test. We prospectively randomized 114 of these patients to receive either 10 d of levofloxacin-concomitant therapy (n = 55) or sequential therapy (n = 59). Antimicrobial resistance of H. pylori isolates collected from the patients with T2DM (n = 109) and dyspeptic controls without DM (n = 110) was determined using the E-test. This study was approved by our Institutional Review Board (A-BR-103-021). RESULTS The H. pylori eradication rates with concomitant therapy were higher than sequential therapy in both intention-to-treat (96.4% versus 81.4%, p = 0.012) and per-protocol (100% versus 85.4%, p = 0.006) analysis. The adverse effects in both groups were similarly mild. In the patients who received sequential therapy, clarithromycin resistance was significantly associated with eradication failure (p = 0.02). There were no significant differences in the antibiotic-resistant rates to amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin between the patients with and without T2DM. CONCLUSIONS Ten days of levofloxacin-containing concomitant therapy is an effective and well-tolerated treatment to eradicate H. pylori infection for T2DM patients. Key messages Ten days of levofloxacin-containing concomitant therapy is well tolerated and superior to clarithromycin-containing sequential therapy for first-line H. pylori eradication in patients with type 2 diabetes. Clarithromycin resistance to H. pylori is the main factor associated with eradication failure in clarithromycin-containing sequential therapy in diabetic patients.
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Affiliation(s)
- Yao-Jong Yang
- a Departments of Pediatrics , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Chung-Tai Wu
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Horng-Yih Ou
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Chin-Han Lin
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Hsiu-Chi Cheng
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Wei-Lun Chang
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Wei-Ying Chen
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Hsiao-Bai Yang
- d Departments of Pathology , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,e Department of Pathology , Ton-Yen General Hospital , Hsin-Chu County , Taiwan
| | - Cheng-Chan Lu
- d Departments of Pathology , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Bor-Shyang Sheu
- b Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,c Departments of Internal Medicine , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan.,f Department of Internal Medicine , Tainan Hospital, Ministry of Health and Welfare , Tainan , Taiwan
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Tian XP, Jiang FQ, Cui Y. Association of Helicobacter pylori infection with type 2 diabetes. Shijie Huaren Xiaohua Zazhi 2016; 24:4555-4561. [DOI: 10.11569/wcjd.v24.i34.4555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The last three decades have witnessed a rapid rise in the number of people with type 2 diabetes (T2DM), and China has the largest population of diabetes in the world. Patients with T2MD are more susceptible to a variety of infections due to impaired host immunity. Helicobacter pylori (H. pylori) hosted in the human stomach is the pathogen of a series of gastric and extragastric diseases, and has infected > 50% of the world population. H. pylori infection is rapidly becoming a serious threat to public health. Epidemiological surveys have indicated an obvious relationship between H. pylori and diabetes. H. pylori infection in T2MD cases can induce systemic inflammation, increase the risk of diabetic nephropathy and retinopathy, and is associated closely with the micro- and macro-vascular complications. Chronic H. pylori infection may have a harmful impact on pancreatic β-cells and may be a risk factor for T2MD and insulin resistance. Treatment of H. pylori infection and control of T2MD are becoming increasingly challenging due largely to the huge population of patients with the two diseases and to the relative complexity of treatment regimens. Further clinical and basic studies are needed to control H. pylori infection and T2MD effectively.
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