The association between Helicobacter pylori infection and diabetes mellitus: an updated meta-analysis of 45 case-control studies
Bibliographic record
Abstract
BACKGROUND: Helicobacter pylori (H. pylori) infection is linked to various gastrointestinal and systemic diseases, including diabetes mellitus (DM). This study synthesizes evidence to determine the association between H. pylori infection and the risk of developing DM. OBJECTIVES: To quantify the odds ratio (OR) of DM in individuals with H. pylori infection and explore variations across different subgroups. METHODS: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Databases including Medline, Web of Science, Scopus, EMBASE, Ovid, and CINHAL were searched for case-control studies from January 1990 to January 2025. Eligible studies investigated the association between H. pylori and DM. Data extraction was performed independently by two reviewers, and study quality was assessed using the Modified Newcastle-Ottawa Scale (NOS). Random-effects models were utilized to calculate pooled ORs, with heterogeneity assessed via I² statistic. Subgroup analyses included H. pylori detection methods, age groups, geographic regions, DM types, HbA1c levels, duration of DM, and study quality. RESULTS: From 280 records, 45 case-control studies were included, involving 529 million diabetes cases worldwide in 2021. The pooled OR was 1.547 (95% CI: 1.243-1.926), indicating that H. pylori infection increases the risk of DM by approximately 1.56 times. Heterogeneity was moderate (I² = 46.03%). Subgroup analyses showed stronger associations with non-invasive H. pylori detection methods (OR = 1.99), in the 40-60 age group (OR = 2.00), and for type 2 diabetes (OR = 2.25). Geographic variations were significant, with Asia showing the highest OR (2.17). No significant publication bias was detected, and sensitivity analyses confirmed the robustness of our findings. CONCLUSION: This meta-analysis confirms a significant association between H. pylori infection and an increased risk of DM, particularly type 2. The findings underscore the potential benefits of considering H. pylori testing in diabetes management strategies, especially in high-risk populations. Further research should focus on longitudinal studies to establish causality and explore biological mechanisms. REGISTRATION: This review was registered in PROSPERO (CRD42025637126).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".