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幽门螺杆菌根除对非酒精性脂肪性肝病患者肝脏脂肪含量的影响:一项随机开放标签临床试验。

The effect of helicobacter pylori eradication on liver fat content in subjects with non-alcoholic Fatty liver disease: a randomized open-label clinical trial.

作者信息

Jamali Raika, Mofid Alireza, Vahedi Homayoon, Farzaneh Rojin, Dowlatshahi Shahab

机构信息

Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

Internal Medicine Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.

出版信息

Hepat Mon. 2013 Dec 6;13(12):e14679. doi: 10.5812/hepatmon.14679. eCollection 2013.

Abstract

BACKGROUND

The role of Helicobacter pylori (HP) in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) is unclear.

OBJECTIVES

The aim of this study was to evaluate the effect of HP eradication on liver fat content (LFC), liver function tests (LFT), lipid profile, and homeostasis model assessment-IR (HOMA-IR) index in NAFLD.

PATIENTS AND METHODS

Dyspeptic patients with increased serum aminotransferase levels were enrolled in the study. The exclusion criteria were factors affecting serum aminotransferase or HP treatment strategy. Participants with persistent elevated serum aminotransferase level and ultrasound criteria for identification of fatty liver were presumed to have NAFLD. "NAFLD liver fat score" was used to classify NAFLD. Those with "NAFLD liver fat score" greater than -0.64 and positive results for urea breath test (UBT), were included. Lifestyle modification was provided to all participants. HP eradication was performed in intervention arm. LFC, fasting serum glucose (FSG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), triglyceride (TG), cholesterol (CHOL), high and low-density lipoprotein (HDL, LDL), and HOMA-IR were checked at baseline and after that, at intervals of eight weeks and twenty four weeks.

RESULTS

One hundred (49 males) patients with the mean age of 43.46 (± 11.52) were studied. Repeated measure ANOVA showed a significant reduction in LFC, anthropometric measurements, and laboratory parameters (except for HDL) in the both groups during the study; however, no significant difference was observed between the groups.

CONCLUSIONS

It seems that HP eradication per se might not affect LFC, LFT, lipid profile, and insulin resistance in dyspeptic NAFLD patients.

摘要

背景

幽门螺杆菌(HP)在非酒精性脂肪性肝病(NAFLD)发病机制中的作用尚不清楚。

目的

本研究旨在评估根除HP对NAFLD患者肝脏脂肪含量(LFC)、肝功能检查(LFT)、血脂谱和稳态模型评估胰岛素抵抗(HOMA-IR)指数的影响。

患者和方法

纳入血清氨基转移酶水平升高的消化不良患者。排除标准为影响血清氨基转移酶或HP治疗策略的因素。血清氨基转移酶水平持续升高且符合超声诊断脂肪肝标准的参与者被认为患有NAFLD。采用“NAFLD肝脏脂肪评分”对NAFLD进行分类。纳入“NAFLD肝脏脂肪评分”大于-0.64且尿素呼气试验(UBT)结果为阳性的患者。所有参与者均接受生活方式干预。干预组进行HP根除治疗。在基线时以及之后每隔8周和24周检查LFC、空腹血糖(FSG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、甘油三酯(TG)、胆固醇(CHOL)、高密度脂蛋白和低密度脂蛋白(HDL、LDL)以及HOMA-IR。

结果

共研究了100例患者(49例男性),平均年龄43.46(±11.52)岁。重复测量方差分析显示,在研究期间两组的LFC、人体测量指标和实验室参数(HDL除外)均显著降低;然而,两组之间未观察到显著差异。

结论

对于消化不良的NAFLD患者,根除HP本身似乎不会影响LFC、LFT、血脂谱和胰岛素抵抗。

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