Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
PLoS One. 2021 Dec 13;16(12):e0260994. doi: 10.1371/journal.pone.0260994. eCollection 2021.
Existing studies have suggested an association between Helicobacter pylori (Hp) infection and nonalcoholic fatty liver disease (NAFLD). We investigated the relationship between Hp infection and NAFLD using controlled attenuation parameter (CAP) and other metabolic factors.
We conducted a retrospective cohort study of apparently healthy individuals who underwent liver Fibroscan during health screening tests between January 2018 and December 2018. Diagnosis of Hp infection was based on a serum anti-Hp IgG antibody test and CAP values were used to diagnose NAFLD.
Among the 1,784 subjects (mean age 55.3 years, 83.1% male), 708 (39.7%) subjects showed positive results of Hp serology. In the multivariate analysis, obesity (body mass index ≥25) (odds ratio [OR] 3.44, 95% confidence interval [CI] 2.75-4.29), triglyceride (OR 2.31, 95% CI 1.80-2.97), and the highest tertile of liver stiffness measurement (OR 2.08, 95% CI 1.59-2.71) were found to be associated with NAFLD, defined by CAP ≥248 dB/m, while Hp-seropositivity showed no association with NAFLD. Serum levels of HDL cholesterol significantly decreased in subjects with Hp-seropositivity compared to HP-seronegativity in both groups with and without NAFLD (P<0.001).
While Hp seropositivity was not associated with CAP-defined NAFLD, serum HDL cholesterol level were negatively associated with Hp-seropositivity in both groups with and without NAFLD. Further clinical and experimental studies are necessary to determine the association between Hp infection and NAFLD.
已有研究提示幽门螺杆菌(Hp)感染与非酒精性脂肪性肝病(NAFLD)之间存在关联。本研究采用受控衰减参数(CAP)和其他代谢因素来探讨 Hp 感染与 NAFLD 之间的关系。
我们对 2018 年 1 月至 12 月期间进行健康筛查时接受肝纤维化检测的人群进行了一项回顾性队列研究。Hp 感染的诊断基于血清抗-Hp IgG 抗体检测,采用 CAP 值诊断 NAFLD。
在 1784 例受试者(平均年龄 55.3 岁,83.1%为男性)中,708 例(39.7%)受试者 Hp 血清学检查结果为阳性。多变量分析显示,肥胖(体质指数≥25)(比值比[OR]3.44,95%置信区间[CI]2.75-4.29)、甘油三酯(OR 2.31,95% CI 1.80-2.97)和最高三分位的肝硬度值(OR 2.08,95% CI 1.59-2.71)与 CAP≥248 dB/m 定义的 NAFLD 相关,而 Hp 血清学阳性与 NAFLD 无关。在有或无 NAFLD 的两组受试者中,与 Hp 血清学阴性者相比,Hp 血清学阳性者的血清高密度脂蛋白胆固醇水平显著降低(P<0.001)。
虽然 Hp 血清学阳性与 CAP 定义的 NAFLD 无关,但在有或无 NAFLD 的两组受试者中,血清高密度脂蛋白胆固醇水平与 Hp 血清学阳性呈负相关。需要进一步的临床和实验研究来确定 Hp 感染与 NAFLD 之间的关系。