| Background:Small intestinal bacterial overgrowth(SIBO)was detected in systemic sclerosis(SSc)in many studies,although current evidence on SIBO in SSc population are controversial.We conducted this systematic review and meta-analysis to elucidate this possible association between SIBO and SSc by summarizing all available data.Methods:A comprehensive literature search of PubMed,Cochrane Library and Embase databases from inception to December 2020 was done for studies correlating SIBO with SSc.Studies were screened,and relevant data were extracted and analyzed.The pooled prevalence of SIBO among SSc patients and the odds ratio(OR)of SIBO among SSc patients compared with healthy controls were calculated.Furthermore,predictors of SIBO in SSc and the effect of antibiotic treatment in SSc patients with SIBO were also evaluated.Results:Fifteen studies containing 781 SSc patients and 256 healthy controls met the inclusion criteria.The pooled prevalence of SIBO in SSc was34%(95% CI 27–42%).The OR of SIBO in SSc patients was 10.77(95%CI6.15–18.86)compared with healthy controls.Subgroup analyses showed that the prevalence of SIBO in SSc was higher in studies diagnosed by lactulose hydrogen breath test(LHBT)(54%,95%CI 45–63%)compared with glucose hydrogen breath test(GHBT)(26%,95%CI 18–33%)and jejunal aspirated culture(JAC)(35%,95%CI 22–48%),and the prevalence of SIBO in SSc was higher in studies from Western countries(38%,95%CI 30–45%)than Eastern countries(15%,95%CI 9–21%).Moreover,the risk of diarrhea was higher in SSc patients with SIBO than those without SIBO(OR 8.82,95%CI4.09–19.00,P<0.05).Finally,gastrointestinal(GI)symptomatic improvement and eradication of SIBO were observed after antibiotic treatment for SIBO in SSc.Conclusion:Around one-third of SSc patients tested positive for SIBO,with a significantly increased risk over controls.The prevalence of SIBO varied according to diagnostic test performed and area of included patients.The presence of diarrhea may be a predictor of SIBO in SSc.Antibiotic treatment may lead to gastrointestinal symptomatic improvement and eradication of SIBO... |
