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幽门螺杆菌感染根除治疗非酒精性脂肪性肝病:一项随机对照试验。

Helicobacter pylori infection eradication for nonalcoholic fatty liver disease: a randomized controlled trial.

机构信息

Department of General Practice, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.

出版信息

Sci Rep. 2022 Nov 14;12(1):19530. doi: 10.1038/s41598-022-23746-0.

Abstract

Previous studies have suggested that Helicobacter pylori (H. pylori) infection is associated with nonalcoholic fatty liver disease (NAFLD). The purpose of the present study was to investigate the effect of H. pylori eradication treatment on NAFLD patients. Two hundred NAFLD patients who tested positive for H. pylori infection were randomized into the H. pylori eradication treatment group or the control group. Metabolic and inflammatory parameters and FibroScan were measured in all subjects at baseline and 1 year after treatment. At 1 year after treatment, the decrease in metabolic indicators, such as fasting blood glucose, glycosylated haemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, body mass index and controlled attenuation parameter values, were more obvious in the treatment group. Moreover, the inflammatory indicators white blood count and high-sensitivity C-reactive protein (hs-CRP) and the inflammatory factors interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α) were also significantly decreased. H. pylori eradication can further reduce the metabolic indices of NAFLD and the degree of liver steatosis. H. pylori infection may participate in the occurrence and development of NAFLD through its influence on inflammatory factors. Thus, checking for the presence of H. pylori infection in patients at risk of NAFLD may be beneficial.

摘要

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)有关。本研究旨在探讨 H. pylori 根除治疗对 NAFLD 患者的影响。将 200 例 H. pylori 感染阳性的 NAFLD 患者随机分为 H. pylori 根除治疗组和对照组。所有患者在基线和治疗 1 年后测量代谢和炎症参数以及 FibroScan。治疗 1 年后,治疗组的代谢指标(如空腹血糖、糖化血红蛋白、胰岛素抵抗稳态模型评估(HOMA-IR)、甘油三酯、体重指数和受控衰减参数值)下降更为明显。此外,炎症指标白细胞计数和高敏 C 反应蛋白(hs-CRP)以及炎症因子白细胞介素 6(IL-6)和肿瘤坏死因子-α(TNF-α)也显著降低。H. pylori 根除可进一步降低 NAFLD 的代谢指标和肝脂肪变性程度。H. pylori 感染可能通过影响炎症因子参与 NAFLD 的发生和发展。因此,对有发生 NAFLD 风险的患者进行 H. pylori 感染检查可能是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36bc/9663549/f6847a1717c7/41598_2022_23746_Fig1_HTML.jpg

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