Association between Helicobacter Pylori Infection and Graves’ Disease: A Meta-Analysis
Abstract: Helicobacter pylori
(H. pylori) infection is proposed to be related with autoimmune diseases, such
as Graves’ Disease (GD). This study aimed to assess the association between H.
pylori infection and GD.
Methods: A systematic literature review was conducted using Pubmed and
Cochrane library. The quality of enrolled studies was assessed by the Critical
Appraisal Skills Program Oxford. A fixed-effect model approach was used if
there was no heterogeneity; otherwise, a random-effect model was used.
Heterogeneity was assessed using I2. Publication bias was assessed by funnel
plot. All data were analyzed using REVIEW MANAGER 5.3.
Results: Six studies from Europe and Asia involving 983 patients were
included. Overall H. pylori infection was significantly associated with GD (OR
2.7; 95% CI: 1.47-4.99; p < 0.001). In subgroup analysis of 3 studies using
non-serological diagnostic method, the prevalence rate of H. pylori infection
was higher in GD group (78.26% VS 42.42%) with significant relationship (OR
4.93; 95% CI: 3.16-7.69; p < 0.00001; I2 = 0%). The CagA antibody prevalence
was significantly higher in GD group (46.57% VS 20.29%; OR 4.41; 95% CI:
2.65-7.33; p < 0.00001; I2 = 56%). No publication bias was observed.
Conclusion: Our study showed association between H. pylori infection and
GD. It might suggest the need of H. pylori examination in GD patients and the
impact of H. pylori eradication in the treatment of GD.
Keywords: Helicobacter pylori,
Graves’ disease, meta-analysis
Author: Guntur Darmawan, Marcellus
Simadibrata, Indah Suci Widyahening
Journal Code: jpkedokterangg170370
