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Association between Helicobacter pylori infection and growth outcomes in children: A meta-analysis
Chenjing Xu1, Yao Wu2, Shunfu Xu1,2
1Department of Gastroenterology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
Helicobacter pylori (H. pylori) infection is linked to growth problems in children, particularly affecting height-for-age Z scores. This finding suggests H. pylori should be considered when diagnosing linear growth disorders in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Growth and Development
Background:
- Conflicting study results exist regarding the association between Helicobacter pylori (H. pylori) infection and children's growth.
- Previous research has explored the link between H. pylori and pediatric growth outcomes with varied conclusions.
Purpose of the Study:
- To conduct a meta-analysis evaluating the association between H. pylori infection and various growth outcomes in children.
- To synthesize existing evidence to clarify the impact of H. pylori on pediatric growth.
Main Methods:
- A systematic search was performed across major databases (PubMed, Embase, Web of Science, Cochrane Library, Wanfang, CNKI) up to September 2019.
- Meta-analysis utilized random-effects models to pool data, calculating Odds Ratios (ORs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs).
- Subgroup and sensitivity analyses were conducted to assess the robustness of the findings.
Main Results:
- The meta-analysis included 29 studies with 9384 subjects.
- H. pylori infection showed a significant association with ponderal growth disorders (OR: 2.47) and linear growth disorders (OR: 1.76).
- A significant adverse impact was observed on children's height-for-age Z (HAZ) scores (SMD = -0.41), while other growth parameters (weight, BMI, etc.) showed no significant association.
Conclusions:
- The evidence supports a link between H. pylori infection and impaired growth outcomes in children, primarily affecting HAZ scores.
- Clinicians should consider H. pylori infection as a potential factor when investigating linear growth disorders in children.
Background:
Multiple studies have reported the association between Helicobacter pylori (H. pylori) infection and children's growth. The results of these studies are controversial. Our meta-analysis aimed to evaluate the association between H. pylori infection and growth outcomes in children.
Methods:
We searched PubMed, Embase, Web of Science, and Cochrane Library, as well as two Chinese databases, Wanfang, and CNKI from inception to September 2019. Odds ratios (ORs) and standardized mean differences (SMDs) with their 95% confidence interval (95% CI) were selected as the effect size. We assessed pooled data using a random-effects model. Subgroup and sensitivity analyses were conducted.
Results:
In total, 29 studies provided data from 9384 subjects. The meta-analysis results indicated a significant association of H. pylori infection with ponderal growth disorders (OR: 2.47; 95% CI: 1.13, 5.37; p = 0.02) and linear growth disorders (OR =1.76; 95% CI: 1.15, 2.69, p = 0.01). H. pylori infection has an adverse impact on children's height-for-age Z (HAZ) scores (SMD = -0.41; 95% CI: -0.69, -0.13; p < 0.01). Pooling SMDs by other outcomes (height, weight, BMI, weight-for-age and BMI-for-age Z scores, weight-for-age percentile scores, and linear and ponderal growth velocity with/without infection and eradication/non-eradication) all indicated no significant association.
Conclusion:
The current evidence supports the hypothesis that H. pylori infection is associated with growth outcomes in children, mainly HAZ scores. Clinicians might consider H. pylori infection in investigating linear growth disorders in children.
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