AUTHOR=Cai Xianlei , Li Xueying , Jin Yangli , Zhang Miaozun , Xu Yuan , Liang Chao , Weng Yihui , Yu Weiming , Li Xiuyang 

TITLE=Vitamins and Helicobacter pylori: An Updated Comprehensive Meta-Analysis and Systematic Review

JOURNAL=Frontiers in Nutrition

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.781333

DOI=10.3389/fnut.2021.781333

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>Over recent decades, epidemiological studies have shown relationships between vitamins and <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infection and eradication, but the results are controversial.</p></sec><sec><title>Methods</title><p>A comprehensive meta-analysis and systematic review were conducted to clarify the relationships between common types of vitamins and <italic>H. pylori</italic>. We applied meta-regression, subgroup analysis and sensitivity analysis to obtain available evidence. Articles published from January 1991 to June 2021 in PubMed, EMBASE, and the Cochrane Library were searched.</p></sec><sec><title>Results</title><p>In total, we identified 48 studies. The results indicate that <italic>H. pylori</italic> -positive patients had lower serum vitamin B<sub>12</sub> [standardized mean difference (SMD) = −0.30; 95% confidence interval (CI): −0.53 – −0.08], folate (SMD = −0.69; 95% CI: −1.34 – −0.04), vitamin C (SMD = −0.37; 95%CI: −0.57 – −0.18) and vitamin D (SMD = −0.34; 95% CI: −0.49 – −0.18) levels than <italic>H. pylori</italic>-negative patients. Patients in which <italic>H. pylori</italic> had been successfully eradicated had higher serum vitamin D levels (SMD = 1.37; 95% CI: 0.37–2.38) than in patients in which eradication had been unsuccessful. The serum vitamin B<sub>12</sub> levels of <italic>H. pylori</italic>-positive patients improved after successful <italic>H. pylori</italic> eradication therapy (SMD = 1.85; 95% CI: 0.81–2.90), and antioxidant vitamin supplementation to an <italic>H. pylori</italic> eradication regimen improved the eradication rate (risk ratio = 1.22; 95% CI: 1.02–1.44 for per-protocol analysis; risk ratio = 1.25; 95% CI: 1.06–1.47 for intention-to-treat analysis).</p></sec><sec><title>Conclusions</title><p><italic>H. pylori</italic> infections decrease the serum levels of several types of vitamins, eradication of <italic>H. pylori</italic> could rescue its adverse effects, and antioxidant vitamin supplementation may improve the <italic>H. pylori</italic> eradication rate.</p></sec><sec><title>Systematic Review Registration</title><p>identifier: CRD42021268127.</p></sec>