Abo-Amer Yousry Esam-Eldin, Sabal Aisha, Ahmed Rehab, Hasan Nabil Fathy Esmael, Refaie Rasha, Mostafa Sahar Mohamed, Mohamed Ahmed Abdelhaleem, Khalil Mahmoud, Elagawy Waleed, Abd-Elsalam Sherief
Hepatology, Gastroenterology and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Gharbia, Egypt.
Hepatology, Tropical Medicine and Infectious Diseases Departments, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Diabetes Metab Syndr Obes. 2020 Mar 2;13:619-625. doi: 10.2147/DMSO.S237866. eCollection 2020.
Non-alcoholic fatty liver disease (NAFLD) is a very common disease that affects 25-30% of the population in western countries. Many studies have observed the importance of infection in the development of insulin resistance, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, and liver fibrosis and cirrhosis. However, the evidence from different studies was controversial. The present study aimed to investigate the relationship between infection and NAFLD in a developing country.
This cross-sectional study included all the attending outpatient clinics at four Major University hospitals and two research and clinical institutes in a developing country in the period between June and October 2019. Patients were assessed for the diagnosis of infection as detected by antigen in stool; they were also assessed for the diagnosis of NAFLD by ultrasound, fibroscan, and CAP.
The study was conducted on 646 patients; infection was found to be present in 538 patients (83.3%). NAFLD (diagnosed by both U/S and Fibroscan with CAP), ALT, AST, hepatomegaly, hypertension, fasting blood sugar were significantly higher in +ve group than -ve group. After performing Linear regression of independent risk factors of NAFLD to prove or to refute the role of Helicobacter; positivity, total cholesterol, degree of fatty liver by ultrasound, fasting blood sugar and diastolic blood pressure were independent risk factors for NAFLD.
infection was independent risk factors for NAFLD and correlated with increased degree of steatosis.
非酒精性脂肪性肝病（NAFLD）是一种非常常见的疾病，在西方国家影响着25%-30%的人口。许多研究已经观察到感染在胰岛素抵抗、非酒精性脂肪性肝病、非酒精性脂肪性肝炎以及肝纤维化和肝硬化发展过程中的重要性。然而，不同研究的证据存在争议。本研究旨在调查在一个发展中国家感染与NAFLD之间的关系。
这项横断面研究纳入了2019年6月至10月期间一个发展中国家的四家主要大学医院以及两家研究和临床机构的所有门诊患者。对患者进行评估，以诊断粪便中抗原检测到的感染情况；还通过超声、肝脏硬度值测定仪和受控衰减参数（CAP）对患者进行NAFLD诊断评估。
该研究共纳入646例患者；发现538例患者（83.3%）存在感染。NAFLD（通过超声和肝脏硬度值测定仪结合CAP诊断）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、肝肿大、高血压、空腹血糖在阳性组显著高于阴性组。在对NAFLD的独立危险因素进行线性回归分析以证实或反驳幽门螺杆菌的作用后；幽门螺杆菌阳性、总胆固醇、超声检查的脂肪肝程度、空腹血糖和舒张压是NAFLD的独立危险因素。
感染是NAFLD的独立危险因素，且与脂肪变性程度增加相关。
