Role of Helicobacter pylori infection and the risk of cholelithiasis

This article aims to deepen the understanding of the role of Helicobacter pylori (H. pylori) infection in the development of cholelithiasis, initiated by the article by Yao et al, who investigated the potential link between H. pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants. They also performed a comprehensive analysis of previously published studies on H. pylori and cholelithiasis, finding a positive association therein [odds ratio (OR) = 1.103, P = 0.049]. Patients positive for H. pylori also had lower levels of total and direct bilirubin, but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients (P < 0.05). Cohort studies have confirmed that H. pylori is a risk factor for cholelithiasis (P < 0.0001), and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H. pylori and cholelithiasis in Asia (OR = 1.599, P = 0.034), but not in Europe (OR = 1.277, P = 0.246). Moreover, H. pylori appears to be related to a higher ratio of choledocholithiasis/cholecystolithiasis (OR = 3.321, P = 0.033). The authors conclude that H. pylori infection is positively correlated with cholelithiasis, particularly with the choledocholithiasis phenotype, especially in Asia, and it is potentially related to bilirubin and cholesterol metabolism.