Wijarnpreecha, Karn

Background/Objectives: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection. Patients with H. pylori infection may be at an increased risk of nonalcoholic fatty liver disease (NAFLD) because of chronic inflammation and insulin resistance. Several epidemiologic studies attempting to determine this risk have yielded inconsistent results. This meta-analysis was conducted with the aims to summarize all available evidence and estimate the risk of NAFLD in patients with H. pylori infection. Methods: A literature search was performed using MEDLINE and EMBASE database from inception to June 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of NAFLD among patients with H. pylori infection versus without H. pylori infection were included. Pooled odds ratios and 95% confidence intervals were calculated using a random-effect, generic inverse variance method. Results: Six studies met our eligibility criteria and were included in this analysis. We found a statistically significant increased risk of NAFLD among patients with H. pylori infection with the pooled odds ratios of 1.21 (95% confidence interval, 1.07-1.37). The statistical heterogeneity was low with an I 2 of 49%. Conclusions: A significantly increased risk of NAFLD among patients with H. pylori infection was demonstrated in this meta-analysis. Further studies are required to clarify how this risk should be addressed in clinical practice.

Abstract Background The association between hyperuricaemia and nonalcoholic fatty liver disease ( NAFLD ), one of the leading causes of cirrhosis worldwide, has been demonstrated in recent epidemiological studies. This meta‐analysis was conducted to summarize all available data and to estimate the risk of NAFLD among subjects with hyperuricaemia. Methods Comprehensive literature review was conducted using MEDLINE and EMBASE database through August 2016 to identify studies that compared the risk of NAFLD among subjects with hyperuricaemia vs those with normal uric acid level. Effect estimates from individual study were extracted and combined together using random‐effect, generic inverse variance method of DerSimonian and Laird. Results Twenty‐five studies met the eligibility criteria and were included in the meta‐analysis. The risk of NAFLD in subjects with hyperuricaemia was significantly higher than subjects with normal uric acid level with the pooled odds ratio ( OR ) of 1.97 (95% confidence interval ( CI ), 1.69‐2.29). The heterogeneity between studies of the overall analysis was high with an I 2 of 87%. Subgroup analysis based on 11 studies that provided data on males subgroup and nine studies that provided data on females subgroup showed that the risk was significantly increased for both sexes with pooled OR of 1.64 (95% CI , 1.40‐1.93) among males and pooled OR of 2.21 (95% CI , 1.85‐2.64) among females. Conclusions A significantly increased risk of NAFLD among patients with hyperuricaemia was demonstrated in this meta‐analysis. Further studies are required to establish the role of uric acid in the pathogenesis of NAFLD .

AbstractBackgroundThe association between periodontitis and systemic diseases has been increasingly recognized. However, the data on the association between periodontitis and psoriasis are still limited.ObjectivesTo summarize all available data on the association between periodontitis and the risk of psoriasis.MethodsTwo investigators independently searched published studies indexed in MEDLINE and EMBASE databases from inception to July 2016 using a search strategy that included terms for psoriasis and periodontitis. Studies were included if the following criteria were met: (i) case–control or cohort study comparing the risk of psoriasis in subjects with and without periodontitis; (ii) subjects without periodontitis were used as comparators in cohort studies while participants without psoriasis were used as controls in case–control studies; and (iii) effect estimates and 95% confidence intervals (CI) were provided. Point estimates and standard errors from each study were extracted and combined together using the generic inverse variance technique described by DerSimonian and Laird.ResultsTwo cohort studies and three case–control studies met the inclusion criteria and were included in the meta‐analysis. The pooled risk ratio of psoriasis in patients with periodontitis versus comparators was 1.55 (95% CI, 1.35–1.77). The statistical heterogeneity was insignificant with an I2 of 18%. Subgroup analysis according to study design revealed a significantly higher risk among patients with periodontitis with a pooled RR of 1.50 (95% CI, 1.37–1.64) for cohort studies and a pooled RR of 2.33 (95% CI, 1.51–3.60) for case–control studies.ConclusionsPatients with periodontitis have a significantly elevated risk of psoriasis.

Background/objectives Nonalcoholic fatty liver disease (NAFLD) is a worldwide public health concern. Coffee might have a protective effect against NAFLD. However, the results of previous reports are conflicting. Therefore, we carried out this meta-analysis to summarize all available data. Methods This study consisted of two meta-analyses. The first meta-analysis included observational studies comparing the risk of NAFLD in patients who did and did not drink coffee. The second analysis included studies comparing the risk of liver fibrosis between NAFLD patients who did and did not drink coffee. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated. Results Out of 355 articles, five studies fulfilled our eligibility criteria and were included in the analysis. The risk of NAFLD in patients who drank coffee was significantly lower than that in patients who did not pooled RR 0.71 (95% CI, 0.60–0.85). We also found a significantly decreased risk of liver fibrosis among NAFLD patients who drank coffee compared with those who did not, with a pooled RR of 0.70 (95% CI, 0.60–0.82). However, it should be noted that the definition of regular coffee consumption varied between studies, which is the main limitation of this meta-analysis. Conclusion Our study found a significantly decreased risk of NAFLD among coffee drinkers and significantly decreased risk of liver fibrosis among patients with NAFLD who drank coffee on a regular basis. Whether consumption of coffee could be considered a preventative measure against NAFLD needs further investigations.

Background/objectives Hepatitis C virus (HCV) infection is one of the most common causes of cirrhosis. Several studies have linked caffeine consumption to a lower degree of liver fibrosis and inflammation among patients with chronic HCV infection, but the results were inconsistent. This meta-analysis was carried out with the aim of assessing the impact of caffeine consumption among HCV-infected patients. Participants and methods A literature search was performed using MEDLINE and EMBASE from inception to January 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of advanced liver fibrosis or the risk of moderate to severe liver inflammation among HCV-infected patients who consumed caffeine on a regular basis versus those who did not were included. Pooled odds ratios (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse-variance method. Results Five studies were included in the fibrosis analysis. The pooled OR of advanced liver fibrosis in HCV-infected patients who consumed caffeine on a regular basis versus those who did not was 0.48 (95% CI, 0.30–0.76, I 2=52%). Three studies were included in the inflammation analysis. The pooled OR of moderate to severe histologic inflammation among HCV-infected patients who consumed caffeine on a regular basis versus those who did not was 0.61 (95% CI, 0.35–1.04, I 2=43%). Conclusion Our study showed a decreased risk of advanced liver fibrosis and liver inflammation among HCV-infected patients who consumed caffeine on a regular basis. Whether consumption of caffeine plays a role in the management of HCV infection requires further investigations.

Background/objectives Gallstone disease and its complications are common, particularly in Western populations. Recent studies have reported a significantly increased risk of gallstones among hepatitis C virus-infected patients. However, the data on patients with hepatitis B virus (HBV) infection are still limited. This meta-analysis was carried out with the aim of summarizing all available evidence. Patients and methods A literature search was performed using MEDLINE and the EMBASE database from inception to May 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of gallstones among HBV-infected patients versus patients without HBV infection were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse-variance method. Results Nine studies fulfilled our eligibility criteria and were included in the analysis. We found no significant association between HBV infection and the risk of gallstones, with a pooled OR of 1.10 (95% CI, 0.91–1.33). The statistical heterogeneity was moderate, with an I 2 of 69%. Subgroup analysis was carried out. The pooled OR of cross-sectional studies was 1.01 (95% CI, 0.91–1.12; I 2 0%), whereas the pooled OR of case–control studies was 1.53 (95% CI, 0.85–2.74; I 2 80%). Conclusion A significant association between HBV infection and the risk of gallstones was not observed in this study.

AbstractBackground and AimNonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Several studies have suggested that short sleep duration could be a risk factor for NAFLD. However, results of those reports are inconsistent. This meta‐analysis was conducted with an attempt to summarize all available data.MethodsA comprehensive literature review was performed using MEDLINE and EMBASE database. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk of NAFLD among participants who had short sleep duration versus those with longer sleep duration were included. Pooled risk ratios and 95% confidence interval were calculated using a random‐effect, generic inverse variance method.ResultsSix studies met the eligibility criteria and were included in the meta‐analysis. The risk of NAFLD in participants who had short sleep duration was significantly higher than participants with longer sleep duration with pooled risk ratios of 1.19 (95% confidence interval, 1.04–1.36, I2 = 0%).ConclusionsOur study demonstrated a small but significantly increased risk of NAFLD among participants who had short sleep duration.

AbstractBackground and Aim:Patients with celiac disease (CD) might be at an increased risk of developing venous thromboembolism (VTE) due to chronic inflammation and vitamin deficiency. However, epidemiologic studies attempting to investigate this risk have yielded inconsistent results. We conducted this meta‐analysis with the aims to better characterize this possible association.Methods:We conducted a systematic review and meta‐analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE in patients with CD versus participants without CD. Generic inverse variance method of DerSimonian and Laird was used to calculate the pooled risk ratio.Results:Out of 279 potentially relevant articles, four studies met the inclusion criteria and were included in the meta‐analysis. We found a statistically significant increased risk of VTE among patients with CD with the pooled risk ratio of 1.25 (95% confidence interval, 1.02–1.53). The statistical heterogeneity was moderate with an I2 of 69%.Conclusions:A significantly increased risk of VTE among patients with CD was demonstrated in this meta‐analysis. Further studies are required to clarify how this risk should be addressed in clinical practice.

AimTo investigate the association between primary biliary cirrhosis (PBC) and risk of coronary artery disease (CAD).MethodsWe conducted a systematic review and meta‐analysis of published observational studies that reported relative risks, odd ratios, hazard ratios or standardized incidence ratios with 95% confidence intervals (CI) comparing CAD risk in patients with PBC versus non‐PBC controls. Pooled risk ratios and 95% confidence intervals were combined using a random‐effect model and generic inverse variance of DerSimonian and Laird methods.ResultFour studies with 3362 patients with PBC were identified and included in our data analysis. The pooled risk ratio of CAD in patients with PBC was 1.57 (95% CI, 1.21–2.06). The statistical heterogeneity was low with an I2 of 38%.ConclusionOur study demonstrated a statistically significant increased risk of CAD among patients with PBC.