Department of Gastroenterology, Ferencváros Health Center, Budapest, Hungary -
Minerva Gastroenterol Dietol. 2020 Sep;66(3):267-279. doi: 10.23736/S1121-421X.20.02671-9.
Helicobacter pylori is the most prevalent infection worldwide, while non-alcoholic fatty liver disease emerged as the most frequent liver disease. The common occurrence can be either by chance or due to certain pathogenetic factors. Epidemiologic studies revealed that the risk of non-alcoholic liver disease is increased in patients infected with Helicobacter pylori. DNA fragments of Helicobacter pylori were rarely identified in human samples of liver carcinoma and fatty liver. Helicobacter pylori could influence the development of non-alcoholic fatty liver either by hormonal (ghrelin? gastrin? insulin?), or by effect of pro-inflammatory cytokines (interleukin 1 and 8, tumor necrosis factor ɑ, interferon ɣ) and by changes of gut microbiome as well. Probiotic supplementation could improve some clinical parameters of non-alcoholic fatty liver disease and eradication rates of Helicobacter pylori. Regimens used for eradication can be safely administered, although non-alcoholic fatty liver increases the risk of drug-induced liver damage. Controlled studies of the effect of eradication on the development and progression of non-alcoholic fatty liver are warranted.
幽门螺杆菌是世界上最普遍的感染,而非酒精性脂肪性肝病则成为最常见的肝脏疾病。这种共同发生既可能是偶然的,也可能是由于某些发病因素。流行病学研究表明,感染幽门螺杆菌的患者发生非酒精性肝病的风险增加。在肝癌和脂肪肝的人类样本中很少发现幽门螺杆菌的 DNA 片段。幽门螺杆菌可能通过激素(ghrelin?胃泌素?胰岛素?)、促炎细胞因子(白细胞介素 1 和 8、肿瘤坏死因子 ɑ、干扰素 ɣ)的作用以及肠道微生物组的变化来影响非酒精性脂肪性肝病的发展。益生菌补充剂可以改善非酒精性脂肪性肝病的一些临床参数和幽门螺杆菌的根除率。虽然非酒精性脂肪性肝病会增加药物性肝损伤的风险,但用于根除的方案可以安全使用。需要进行对照研究,以确定根除对非酒精性脂肪性肝病的发展和进展的影响。