Clinical data regarding Helicobacter pylori (Hp) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was the evaluation of Hp infection in patients with NAFLD and its association with disease severity.
28 patients with biopsy-proven NAFLD (15 with simple nonalcoholic fatty liver [NAFL], 13 with nonalcoholic steatohepatitis [NASH]) and 25 matched healthy controls were recruited. Blood samples for anti-Hp Immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting, and 13C urea breath test was performed before liver biopsy in NAFLD group.
Higher rates of anti-Hp IgG (P=.038) were observed in NAFLD compared to control group. Only two NAFLD patients neither were Hp IgG seropositive nor did they have a history of eradication treatment compared to 11 control subjects (P=.002). Both Hp infection (assessed by history of Hp eradication treatment and/or Hp IgG seropositivity) (P=.034) and log(HOMA-IR) (P=.007) could independently predict NAFLD in logistic regression analysis. There were similar rates of Hp IgG seropositivity or positivity in 13C urea breath test or their combination between NAFL and NASH patients. There were no significant differences in steatosis grade, fibrosis stage, lobular or portal inflammation, or ballooning, when NAFLD patients were divided according to Hp IgG seropositivity or 13C urea breath test positivity.
Hp infection may represent one more hit contributing to the pathogenesis of NAFL, though not to the progression from NAFL to NASH. These results warrant further validation. If confirmed, eradicating Hp infection may have certain therapeutic perspectives in NAFLD treatment.
Abbreviations:ALT (alanine transaminase), AST (aspartate transaminase), BMI (body mass index), CV (coefficient of variation), GGT (gamma-glutamyl transferase), HMW (high molecular weight), HOMA-IR (homeostatic model of assessment - insulin resistance), Hp (Helicobacter pylori), hsCRP (high sensitivity C-reactive protein), IgG (immunoglobulin G), IR (insulin resistance), LDL-C (low-density lipoprotein cholesterol), NAFL (simple nonalcoholic fatty liver), NAFLD (nonalcoholic fatty liver disease), NAS (NAFLD Activity Score), NASH (nonalcoholic steatohepatitis), T2DM (type 2 diabetes mellitus), TNF (tumor necrosis factor)
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Published online: July 30, 2012
Accepted: June 22, 2012
Received: April 4, 2012
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