| Summary: | <p>Abstract</p> <p>Background</p> <p>The nature of the association between ghrelin, an orexigenic hormone produced mainly in the stomach, and <it>Helicobacter </it><it>pylori (H pylori)</it>, a bacterium that colonises the stomach, is still controversial. We examined available evidence to determine whether an association exists between the two; and if one exists, in what direction.</p> <p>Methods</p> <p>We reviewed original English language studies on humans reporting circulating ghrelin levels in <it>H pylori </it>infected and un-infected participants; and circulating ghrelin levels before and after <it>H pylori </it>eradication. Meta-analyses were conducted for eligible studies by combining study specific estimates using the inverse variance method with weighted average for continuous outcomes in a random effects model.</p> <p>Results</p> <p>Seventeen out of 27 papers that reported ghrelin levels in <it>H pylori </it>positive and negative subjects found lower circulating ghrelin levels in <it>H pylori </it>positive subjects; while 10 found no difference. A meta-analysis of 19 studies with a total of 1801 participants showed a significantly higher circulating ghrelin concentration in <it>H pylori </it>negative participants than in <it>H pylori </it>positive participants (Effect estimate (95%CI) = -0.48 (-0.60, -0.36)). However, eradicating <it>H pylori </it>did not have any significant effect on circulating ghrelin levels (Effect estimate (95% CI) = 0.08 (-0.33, 0.16); Test for overall effect: Z = 0.67 (P = 0.5)).</p> <p>Conclusions</p> <p>We conclude that circulating ghrelin levels are lower in <it>H pylori </it>infected people compared to those not infected; but the relationship between circulating ghrelin and eradication of <it>H pylori </it>is more complex.</p>
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