Hepatic Encephalopathy in Cirrhotic Patients and Risk of Small Intestinal Bacterial Overgrowth: A Systematic Review and Meta-Analysis.

Background. Hepatic encephalopathy (HE) is a neurological and psychiatric syndrome. Recent evidence suggests that HE is not only a disease of the liver and brain but is also related to the gut. Small intestinal bacterial overgrowth (SIBO) is well known to be associated with cirrhosis, but the relati...

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Publicado en:BioMed Research International pp. 1 - 9
Autores principales: Feng, Xin, Li, Xiaoqing, Zhang, Xin, Chen, Weiqing, Tian, Yin, Yang, Qingqing, Yang, Yingying, Pan, Hui, Jiang, Zheng
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell 10/18/2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 10/18/2022
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1155/2022/2469513
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        atl: Hepatic Encephalopathy in Cirrhotic Patients and Risk of Small Intestinal Bacterial Overgrowth: A Systematic Review and Meta-Analysis.
      aug:
        au:
          Feng, Xin
          Li, Xiaoqing
          Zhang, Xin
          Chen, Weiqing
          Tian, Yin
          Yang, Qingqing
          Yang, Yingying
          Pan, Hui
          Jiang, Zheng
        affil: Department of Gastroenterology, The People's Hospital of Yubei District of Chongqing City, Chongqing 401120, China
      sug:
        subj:
          Hepatic Encephalopathy Risk Factors
          Liver Cirrhosis
          Intestine, Small Microbiology
          Gut Microbiota
          Bacterial Colonization
          Risk Assessment
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Embase
          Gastrointestinal Transit
          Severity of Illness
          Descriptive Statistics
          Odds Ratio
          Confidence Intervals
      ab: Background. Hepatic encephalopathy (HE) is a neurological and psychiatric syndrome. Recent evidence suggests that HE is not only a disease of the liver and brain but is also related to the gut. Small intestinal bacterial overgrowth (SIBO) is well known to be associated with cirrhosis, but the relationship between SIBO and HE is unclear. We conducted this comprehensive systematic review and meta-analysis to determine the association between SIBO and HE in cirrhotic patients. Methods. We conducted a comprehensive literature search of all studies on the association of SIBO and HE in cirrhotic patients using the PubMed and Embase electronic databases. Studies were screened, and relevant data were extracted and analysed. We calculated the number of cases of SIBO in patients with HE and controls. We then compared the prevalence of SIBO between the two groups to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Funnel plots were constructed to identify potential publication bias. Results. Six studies with 414 participants (219 HE patients and 195 controls) met the inclusion criteria. The prevalence of SIBO in cirrhotic patients with HE was significantly higher than that in those without HE. The combined OR was 4.43 (95% CI 1.73-11.32, P = 0.002). The heterogeneity was moderate ( I 2 = 66 %), and the funnel plot suggested no significant publication bias. Subgroup analysis showed that the OR was 1.95 (95% CI 0.63–6.09) in studies using the lactulose breath test (LBT) and 7.60 (95% CI 3.50–16.50) in studies using the glucose breath test (GBT). The prevalence of SIBO in cirrhotic patients was also related to the severity of liver disease. Conclusions. Our meta-analysis identified a strong association between SIBO and HE, and the risk of SIBO was 4.43 times higher among cirrhotic patients with HE than among those without HE. SIBO could be a predisposing factor for the development of HE in cirrhotic patients. Therefore, the importance of SIBO should be emphasized in patients with HE.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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