Meta-Analysis
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World J Gastroenterol. Oct 28, 2014; 20(40): 14965-14972
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14965
Association between Helicobacter pylori infection and migraine: A meta-analysis
Jing Su, Xiao-Ying Zhou, Guo-Xin Zhang
Jing Su, Xiao-Ying Zhou, Guo-Xin Zhang, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Jing Su, Xiao-Ying Zhou, First Clinical Medical College of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Su J and Zhou XY collected and analyzed the data, and wrote the first draft of the paper; These authors contribute equally to the paper; Zhang GX contributed to the study design and proofread the manuscript.
Supported by National Natural Science Foundation of China, No. 81270476; the Priority Academic Program Development of Jiangsu Higher Education Institutions, JX10231801
Correspondence to: Guo-Xin Zhang, Professor, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, No. 300 of Guangzhou Road, Nanjing 210029, Jiangsu Province, China. guoxinz@njmu.edu.cn
Telephone: +86-25-83718836 Fax: +86-25-83674636
Received: November 7, 2013
Revised: March 11, 2014
Accepted: June 13, 2014
Published online: October 28, 2014
Abstract

AIM: To quantify the association between Helicobacter pylori (H. pylori) infection and migraine.

METHODS: A systematic literature search of PubMed and EMBASE was conducted from inception to December 2013. Studies that provided data dealing with H. pylori infection in patients with migraine, as well as healthy controls, were selected. Meta-analysis was carried out using the odds ratio (OR) with a fixed or random effects model, and a 95%CI for the OR was calculated. An unconditional logistic regression model was used to analyze potential parameters related to H. pylori prevalence. Subgroup analyses were conducted as methods of detection and evidence grade.

RESULTS: Five case-control studies published between 2000 and 2013 were finally identified, involving 903 patients, with a total H. pylori infection rate of 39.31%. The prevalence of H. pylori infection was significantly greater in migraineurs than in controls (44.97% vs 33.26%, OR = 1.92, 95%CI: 1.05-3.51, P = 0.001). A sensitivity test indicated that no single study dominated the combined results. Univariate regression analysis found that publication year, geographical distribution and evidence grade were relevant to the results and were the main reason for the heterogeneity. Subgroup analysis found a significantly greater infection rate of H. pylori in Asian patients with migraine, but no statistically significant infection rate in European patients. The ORs were 3.48 (95%CI: 2.09-5.81, P = 0.000) and 1.19 (95%CI: 0.86-1.65, P = 0.288), respectively.

CONCLUSION: The pooled data suggest a trend of more frequent H. pylori infections in patients with migraine.

Keywords: Helicobacter pylori, Migraine, Meta-analysis, Odds ratio, Subgroup analysis

Core tip: Recently, researchers have focused on the relationship between migraine and Helicobacter pylori (H. pylori) infection. Some studies have reported a strong positive correlation, and eradication of the bacterium resulted in a decrease in migraine attacks. Meanwhile, others have indicated totally negative results. In this meta-analysis, we found a trend of more frequent H. pylori infection in patients with migraine; thus, the eradication of this bacterium may reduce the clinical manifestations in migraineurs. Moreover, subgroup analysis found a significantly greater infection rate of H. pylori in patients with migraine in Asia compared with other countries.