Association between Helicobacter pylori infection and delayed growth in children: A meta-analysis
Association between Helicobacter pylori infection and delayed growth in children: A meta-analysis
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幽门螺杆菌感染与儿童生长迟缓之间的关联：荟萃分析
DOI：
10.3892/etm.2020.8654
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发表时间：
2020-06-01
影响因子：
2.7
通讯作者：
Zhang, Guoxin
中科院分区：
文献类型：
--
作者：
Wei, Shuchun;Dang, Yini;Zhang, Guoxin
幽门螺杆菌（H. pylori）感染与儿童胃肠外疾病有关。本研究旨在探讨H.幽门螺杆菌感染与儿童生长发育全面检索了PubMed、Pubta Medica dataBASE、科克伦图书馆和中国生物医学文献数据库中1994年1月1日至2019年1月1日的相关出版物。根据世界卫生组织儿童生长图表（2006年版）中的年龄相关标准定义儿童生长迟缓。使用固定效应模型合并比值比（OR）和95% CI，使用Review Manager（版本5.3;科克伦）和STATA（版本12.0; StataCorp LP）软件进行亚组和敏感性分析。本研究共纳入了15项观察性研究，包括4，199例受试者。在H. pylori阳性儿童与H. pylori阴性儿童（OR，1.51; 95% CI，1.28-1.78），特别是线性增长（OR，1.63; 95% CI，1.32-2.00）。上述关联仅在H.采用13 C-尿素呼气试验（OR，1.72; 95%CI，1.22-2.40）或血清抗幽门螺杆菌IgG抗体检测幽门螺杆菌感染。pylori感染（OR为1.81; 95% CI为1.35-2.44）。H.幽门螺杆菌感染也与儿童生长迟缓有关。pylori患病率≤30%（OR，1.71; 95% CI，1.31-2.23）或>30%但不>50%（OR，1.43; 95% CI，1.10-1.86）。感染与生长之间的关联仅在横断面（OR，1.43; 95%CI，1.18-1.73）和病例对照（OR，1.81; 95%CI，1.23-2.67）研究中具有统计学显著性。本分析中未发现研究间存在显著异质性。根据Begg和Egger漏斗图和定量评估的线性回归方法，未发现发表偏倚。修剪和填充方法进一步表明，H。pylori阳性的儿童倾向于延迟线性生长。因此，本研究提示预防和检测H.儿童幽门螺杆菌感染可能对确保儿童期正常生长和发育至关重要。
Helicobacter pylori (H. pylori) infection is associated with extra-gastrointestinal diseases in children. The present study aimed to investigate the potential association between H. pylori infection and growth in children. The PubMed, Exerpta Medica dataBASE, Cochrane Library and Chinese Biomedical Literature Database databases were comprehensively searched for relevant publications dated between January 1st 1994 and January 1st 2019. Delayed childhood growth was defined according to the age-appropriate criteria in the World Health Organization Child Growth Charts (2006 edition). The odds ratios (ORs) and 95% CIs were pooled using the fixed-effects model and subgroup and sensitivity analyses were performed using Review Manager (version 5.3; Cochrane) and STATA (version 12.0; StataCorp LP) software. A total of 15 observational studies comprising 4,199 subjects were included in the present study. A higher frequency of delayed growth was observed in H. pylori-positive children compared with that in H. pylori-negative children (OR, 1.51; 95% CI, 1.28-1.78), particularly for linear growth (OR, 1.63; 95% CI, 1.32-2.00). The aforementioned association was only observed when H. pylori infection was detected using 13C-urea breath tests (OR, 1.72; 95% CI, 1.22-2.40) or serum IgG antibodies targeted against H. pylori (OR, 1.81; 95% CI, 1.35-2.44). H. pylori infection was also associated with delayed childhood growth in studies with a H. pylori prevalence of ≤30% (OR, 1.71; 95% CI, 1.31-2.23) or >30% but not >50% (OR, 1.43; 95% CI, 1.10-1.86). The association between infection and growth was only statistically significant in the cross-sectional (OR, 1.43; 95% CI, 1.18-1.73) and case-control (OR, 1.81; 95% CI, 1.23-2.67) studies. No significant heterogeneity among studies was identified in the present analysis. According to Begg's and Egger's linear regression methods for funnel plots and quantification assessments, no publication bias was identified. The trim and fill method further suggested that H. pylori-positive children were prone to delayed linear growth. Therefore, the present study suggested that preventing and detecting H. pylori infection in children may be critical to ensure normal growth and development during childhood.