Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis
Shuo-Yi Yao, Xin-Meng Li, Ting Cai, Ying Li, Lun-Xi Liang, Xiao-Ming Liu, Yu-Feng Lei, Yong Zhu, Fen Wang
Shuo-Yi Yao, Xin-Meng Li, Ting Cai, Lun-Xi Liang, Xiao-Ming Liu, Fen Wang, Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China
Shuo-Yi Yao, Xin-Meng Li, Ting Cai, Lun-Xi Liang, Xiao-Ming Liu, Fen Wang, Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha 410006, Hunan Province, China
Ying Li, Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China
Yu-Feng Lei, Department of Gastroenterology, Shanxi Coal Central Hospital, Taiyuan 030006, Shanxi Province, China
Yong Zhu, Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Co-first authors: Shuo-Yi Yao and Xin-Meng Li.
Co-corresponding authors: Yong Zhu and Fen Wang.
Author contributions: Cai T and Li Y contributed to the methodology and resources; Yao SY and Li XM made validation and formal analysis and wrote the original draft; Yao SY, Li XM, and Cai T cured the data; Cai T, Liang LX, and Liu XM supervised the research; Wang F reviewed and edited the article; Liang LX, Liu XM, and Wang F acquired the funding; Lei YF, Zhu Y, and Wang F conceptualized and administrated the project. Zhu Y and Wang F are the co-corresponding authors of the article. Yao SY and Li XM contributed equally to this work. All authors have read and agreed to the published version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82270594; the National Natural Science Foundation for Youths of China, No. 82103151; the Outstanding Youth Foundation of Hunan Province, No. 2022JJ20092; and the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hospital of Central South University, No. YX202103.
Institutional review board statement: This study was conducted in accordance with the principles of the Declaration of Helsinki, and was approved by the clinical research ethics committee of every center (Ethics Committee Approval No. 23277, No. Z-2024-028, and No. G-2024-11).
Informed consent statement: The requirement to obtain informed written consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Fen Wang, MD, PhD, Professor, Department of Gastroenterology, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha 410013, Hunan Province, China.
wfen-judy@csu.edu.cn
Received: July 20, 2024
Revised: September 5, 2024
Accepted: September 23, 2024
Published online: December 21, 2024
Processing time: 128 Days and 15.5 Hours
BACKGROUND
Helicobacter pylori (H. pylori) is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. H. pylori infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of H. pylori in the development of cholelithiasis remains inconclusive.
AIM
To investigate the potential association between H. pylori infection and the development of cholelithiasis.
METHODS
We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between H. pylori and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of H. pylori on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about H. pylori and cholelithiasis was also executed.
RESULTS
In our multi-center study, H. pylori was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, P = 0.049]. Furthermore, H. pylori patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in H. pylori-positive participants (P < 0.05). In the published articles, the cohort studies indicated H. pylori was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, P < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between H. pylori and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, P = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, P = 0.246). Besides, H. pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, P = 0.033).
CONCLUSION
H. pylori is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in H. pylori patients.
Core Tip: Helicobacter pylori (H. pylori) infection in the biliary system has been identified but its relationship with cholelithiasis is not clear. This study is to analyze the possible correlation between H. pylori and cholelithiasis, and found that H. pylori infection was associated with an increased risk of cholelithiasis, particularly the choledocholithiasis phenotype. The metabolism of bilirubin and cholesterol could be a possible explanation for the link between H. pylori and cholelithiasis. Patients with H. pylori should be screened for cholelithiasis, and H. pylori eradication may help prevent cholelithiasis. In the management of cholelithiasis, the potential influence of H. pylori infection should also be considered.
