Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials

Abstract

Background. Helicobacter pylori (H. pylori) infection and iron deficiency anemia are prevalent in disadvantaged populations worldwide. The benefit of H. pylori eradiation for iron deficiency anemia has been extensively studied, but data are still equivocal. Methods. A search in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing anti-H. pylori plus oral iron to oral iron alone for the iron deficiency patients in whom H. pylori was positive were selected for meta-analysis. Reviev Manager 5.0 software was used for the performance of meta-analysis. Results. Sixteen randomized controlled trials totaling 956 patients were included. The meta-analysis showed that the difference from baseline to endpoint of hemoglobin (Hb), serum iron (SI), and serum ferritin (SF) was statistically significantly different between anti-H. pylori treatment plus oral iron and oral iron alone (SMD, Hb 1.48; 95% CI, 0.96, 2.00; p < 0.00001; SI 1.15; 95% CI, 0.87, 1.43; p < 0.00001; SF 1.84; 95% CI, 1.20, 2.48; p < 0.00001, respectively). Conclusions. Our study suggests that treatment of H. pylori infection could be effective in improving anemia and iron statue in IDA patients infected by H. pylori, particularly in patients with moderate or severe anemia.

Key Words::

• Helicobacter pylori
• iron deficiency anemia
• meta-analysis

Acknowledgements

This study was founded by Natural Science Foundation of China (No.30870364), and not funded by any pharmaceutical company. Yuan Wenzhen and Li Yumin conceived and drafted the manuscript. Yuan Wenzhen, Li Yumin and Yang Kehu contributed to the selection of studies and data extraction. All authors contributed to the study design, data analysis, and interpretation of results, and reviewed the manuscript for important intellectual content and approved the final version. Yuan Wenzhen is a guarantor.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.