Effect of Helicobacter pylori eradication on iron deficiency

Iron deficiency (ID) is still a great challenge to health care worldwide. Results of randomized controlled trials (RCTs) evaluating the effect of Helicobacter pylori (H. pylori) eradication on ID are contradictory. This study aimed to evaluate the effect of H. pylori eradication on ID with a meta-analysis of RCTs.

Five electronic databases were searched for RCTs evaluating the effect of H. pylori eradication on ID. Summary effects were assessed with the methods recommended by the Cochrane Collaboration.

Eight studies involving 800 participants were included in this meta-analysis. The overall analysis showed that H. pylori eradication accelerated the improvement of ferritin levels in ID people (mean difference (MD), 7.74 microg/L; 95%CI, 4.61 to 10.88; P < 0.00001). In a subgroup analysis, H. pylori eradication accelerated the improvement of ferritin levels one month (MD, 7.00 microg/L; 95%CI, 1.72 to 12.28; P = 0.009) and two months (MD, 9.80 microg/L; 95%CI, 2.22 to 17.40; P = 0.01) after the initiation of treatment. However, H. pylori eradication did not show a beneficial effect on the improvement of ferritin levels three months (MD, 7.20 microg/L; 95%CI, -3.25 to 17.65; P = 0.18), one year (MD, 10.17 microg/L; 95%CI, -1.00 to 21.34; P = 0.07) and forty months (MD, 1.00 microg/L; 95%CI, -0.57 to 2.57; P = 0.21) after the initiation of treatment. H. pylori eradication did not accelerate the improvement of hemoglobin concentrations in the overall analysis (MD, 0.38 g/dl; 95%CI, -0.45 to 1.22; P = 0.37). In a subgroup analysis, H. pylori eradication did not accelerate the improvement of hemoglobin concentrations one month (MD, -0.48 g/dl; 95%CI, -2.39 to 1.42; P = 0.62), three months (MD, -0.10 g/dl; 95%CI, -0.35 to 0.15; P = 0.44) and forty months (MD, 0.10 g/dl; 95%CI, -0.37 to 0.57; P = 0.68) after the initiation of treatment. However, H. pylori eradication accelerated the improvement of hemoglobin concentrations two months (MD, 1.96 g/dl; 95%CI, 1.48 to 2.44; P < 0.00001) and one year (MD, 0.37 g/dl; 95%CI, 0.08 to 0.65; P = 0.01) after the initiation of treatment.

H. pylori eradication is likely to improve the absorption of oral ferrous. H. pylori infection may play some roles in the development of ID.