Impact of Helicobacter pylori infection on iron deficiency anemia in children: a systematic review and meta-analysis with early intervention implications
Bibliographic record
Abstract
Background This study investigates the association between Helicobacter pylori (H. pylori) infection and iron deficiency (ID) as well as its potential link to iron deficiency anemia (IDA) in children. Methods As of August 2024, we conducted a comprehensive literature review using the Embase, PubMed, Web of Science, Ovid Medline, and Cochrane databases to compare the risk of IDA in patients with and without H. pylori infection. The Newcastle-Ottawa Quality Assessment Scale was used to assess the methodological quality of the included studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted from the studies, and data were transformed for meta-analysis. Heterogeneity was evaluated using the I2statistic, and homogeneity was tested with the chi-square test. If the I2 value was 50% or greater, a random-effects model was applied; if the I2 value was below 50%, a fixed-effects model was used. The meta-regression was performed to explore the potential sources of heterogeneity. Additionally, a meta-analysis was conducted to assess the changes in hemoglobin and ferritin concentrations before and after H. pylori eradication. Results We analyzed data from patients across 13 countries. Our findings reveal that individuals infected with H. pylori have a higher likelihood of developing ID compared to those uninfected, with an OR = 1.52 (p < 0.00001, 95% CI 1.32–1.74, I2 = 44%). The risk of IDA is also higher in patients with H. pylori, with an OR = 1.83 (p = 0.05, 95% CI 1.01–3.33, I2 = 67%). Conversely, the overall effect of H. pylori infection on anemia is minimal, with an OR = 0.94 (p = 0.64, 95% CI 0.73–1.21, I2 = 96%). Meta-regression results suggest that age is the main source of heterogeneity. A meta-analysis of treatment-related randomized controlled trials revealed that combining iron supplementation with H. pylori eradication therapy significantly raised ferritin levels, with an SMD (Standardized Mean Difference) = 0.86 (p = 0.02, 95% CI 0.14–1.57, I2 = 89%). Hemoglobin levels also showed an increase, with an SMD = 0.47 (p = 0.04, 95% CI 0.01–0.93, I2 = 75%). Conclusion In children, there is a significant association between H. pylori infection and both ID and IDA. Additionally, the eradication of H. pylori has been shown to lead to an improvement in iron stores. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=426395 . PROSPERO ID: CRD42023426395.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.039 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.043 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".