Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Gastroenterol. 2017 Nov;52(11):1201-1210. doi: 10.1007/s00535-017-1337-y. Epub 2017 Apr 5.
Previous studies have suggested a link between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD), yet large-scale longitudinal studies are lacking to elucidate this association.
A cohort study of 17,028 adults without NAFLD at baseline, who participated in a repeated health screening examination including an H. pylori-specific immunoglobulin G antibody test, was conducted to evaluate the association between H. pylori and NAFLD development. Fatty liver was diagnosed by ultrasonography.
During the 83,130 person-years follow-up, participants with H. pylori infection had a higher rate of incident NAFLD than those who were uninfected. In a multivariable model adjusted for age, sex, body mass index, smoking status, alcohol intake, regular exercise, year of screening exam, and education level, the hazard ratio (HR) for NAFLD development in participants with H. pylori infection compared to those without infection was 1.21 [95% confidence interval (CI), 1.10-1.34]. The association persisted after further adjustment for metabolic variables, inflammatory marker, and liver enzymes. The association between H. pylori and NAFLD was still evident in an analysis using fatty liver index as a surrogate marker of NAFLD. In addition, the association between H. pylori infection and incident NAFLD did not differ across clinically relevant subgroups evaluated.
H. pylori infection was significantly associated with the development of NAFLD, independent of metabolic and inflammatory risk factors. H. pylori infection may play a pathophysiologic role in NAFLD development, indicating that H. pylori eradication might play a role in reducing the risk of NAFLD.
先前的研究表明，幽门螺杆菌（H. pylori）感染与非酒精性脂肪性肝病（NAFLD）之间存在关联，但缺乏大规模的纵向研究来阐明这种关联。
本研究纳入了 17028 名基线时无 NAFLD 的成年人，他们参加了一项重复的健康筛查检查，包括 H. pylori 特异性免疫球蛋白 G 抗体检测，以评估 H. pylori 与 NAFLD 发展之间的关系。通过超声检查诊断脂肪肝。
在 83130 人年的随访期间，感染 H. pylori 的参与者发生 NAFLD 的发生率高于未感染者。在调整年龄、性别、体重指数、吸烟状况、饮酒量、规律运动、筛查检查年份和教育程度后，感染 H. pylori 的参与者发生 NAFLD 的风险比（HR）与未感染者相比为 1.21（95%置信区间[CI]，1.10-1.34）。进一步调整代谢变量、炎症标志物和肝酶后，这种关联仍然存在。使用脂肪肝指数作为 NAFLD 的替代标志物进行分析时，H. pylori 与 NAFLD 之间的关联仍然明显。此外，在评估的各个临床相关亚组中，H. pylori 感染与新发 NAFLD 之间的关联并无差异。
H. pylori 感染与 NAFLD 的发生显著相关，独立于代谢和炎症危险因素。H. pylori 感染可能在 NAFLD 的发生发展中起病理生理作用，提示 H. pylori 根除可能在降低 NAFLD 风险方面发挥作用。
