Small intestinal bacterial overgrowth and nonalcoholic... : European Journal of Gastroenterology & Hepatology (original) (raw)

Original Articles: Hepatology

Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease: a systematic review and meta-analysis

Wijarnpreecha, Karna,,b; Lou, Susanc; Watthanasuntorn, Kanramona; Kroner, Paul T.b; Cheungpasitporn, Wisitd; Lukens, Frank J.b; Pungpapong, Surakitb; Keaveny, Andrew P.b; Ungprasert, Patomponge

aDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, New York

bDivision of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida

cDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota

dDepartment of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA

eDepartment of Research and Development, Clinical Epidemiology Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Received 11 June 2019 Accepted 16 July 2019

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Correspondence to Karn Wijarnpreecha, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA, Tel: +1 904 953 6970; fax: +1 904 953 6225; e-mail: [email protected]

European Journal of Gastroenterology & Hepatology 32(5):p 601-608, May 2020. | DOI: 10.1097/MEG.0000000000001541

Abstract

Objectives

Recent studies have suggested that small intestinal bacterial overgrowth (SIBO) could be a predisposing factor for nonalcoholic fatty liver disease (NAFLD) although the results were inconsistent. This systematic review and meta-analysis was conducted with the aim to summarize all available data.

Methods

A comprehensive literature review was conducted utilizing MEDLINE and EMBASE databases through September 2018 to identify all studies that compared the risk of NAFLD among patients with SIBO versus those without SIBO. Effect estimates from each study were extracted and combined together using the random effect, generic inverse variance method of DerSimonian and Laird.

Results

A total of 10 studies with 1093 participants fulfilled the eligibility criteria and were included in the meta-analysis. A significant association between NAFLD and SIBO was observed with the pooled odds ratio of 3.82 (95% confidence interval, 1.93–7.59; _I_2 65%). Funnel plot is relatively symmetric and is not suggestive of the presence of publication bias.

Conclusion

A significant association between NAFLD and SIBO was observed in this meta-analysis.