Relevance between Helicobacter Pylori Infection and Non-Alcoholic Fatty Liver Disease in Tertiary Care Hospital
DOI:
https://doi.org/10.70749/ijbr.v3i5.2740Keywords:
Helicobacter Pylori, Nonalcoholic Fatty Liver Disease, Metabolic Dysfunction, Dyslipidemia, Insulin Resistance, Hepatic Steatosis.Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver disease worldwide, strongly linked to obesity, insulin resistance, and dyslipidemia. Emerging evidence suggests that infectious agents, particularly Helicobacter pylori, may contribute to metabolic dysfunction and hepatic steatosis through systemic inflammation, oxidative stress, and disruption of lipid metabolism. However, the nature and strength of this association remain uncertain, especially in South Asian populations where both H. pylori infection and metabolic disorders are highly prevalent. Aim: This study aimed to investigate the association between H. pylori infection and NAFLD, and to assess related metabolic and anthropometric correlates among adults attending a tertiary-care hospital in Peshawar, Pakistan. Methods: A retrospective cross-sectional study was conducted on 200 adult participants evaluated between June and November 2024. H. pylori infection was diagnosed using urea breath or stool antigen testing, and NAFLD was identified and graded by abdominal ultrasonography. Anthropometric, clinical, and biochemical data were compared between H. pylori–positive and – negative participants. Statistical analyses included chi-square and independent t-tests for group comparisons, multivariable logistic regression for predictors of NAFLD, and Spearman’s rho (ρ) for correlation analysis. Results: H. pylori infection was present in 55.0% of participants, while NAFLD was diagnosed in 35.0%. The prevalence of NAFLD was higher in H. pylori–positive individuals (38.2%) than in uninfected ones (31.1%). Obesity, dyslipidemia, and type 2 diabetes were significantly more common among infected participants. H. pylori infection remained an independent predictor of NAFLD (p = 0.041). NAFLD showed positive correlations with dyslipidemia (ρ ≈ 0.61) and BMI (ρ ≈ 0.54). Conclusion: H. pylori infection is significantly associated with NAFLD and its metabolic correlates, suggesting a contributory role in hepatic steatosis through inflammatory and metabolic pathways. Longitudinal and interventional studies are warranted to clarify causality and evaluate the impact of eradication therapy.
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References
1. Lekakis, V., & Papatheodoridis, G. V. (2024). Natural history of metabolic dysfunction-associated steatotic liver disease. European Journal of Internal Medicine, 122, 3-10.
https://doi.org/10.1016/j.ejim.2023.11.005
2. Devi, J., Raees, A., & Butt, A. S. (2022). Redefining non-alcoholic fatty liver disease to metabolic associated fatty liver disease: Is this plausible? World Journal of Hepatology, 14(1), 158-167.
https://doi.org/10.4254/wjh.v14.i1.158
3. Friedman, S. L., Neuschwander-Tetri, B. A., Rinella, M., & Sanyal, A. J. (2018). Mechanisms of NAFLD development and therapeutic strategies. Nature Medicine, 24(7), 908-922.
https://doi.org/10.1038/s41591-018-0104-9
4. Sun, Q., Yuan, C., Zhou, S., Lu, J., Zeng, M., Cai, X., & Song, H. (2023). Helicobacter pylori infection: A dynamic process from diagnosis to treatment. Frontiers in Cellular and Infection Microbiology, 13.
https://doi.org/10.3389/fcimb.2023.1257817
5. Liu, Y., Shuai, P., Chen, W., Liu, Y., & Li, D. (2023). Association between Helicobacter pylori infection and metabolic syndrome and its components. Frontiers in Endocrinology, 14.
https://doi.org/10.3389/fendo.2023.1188487
6. Abo-Amer, Y. E., Sabal, A., Ahmed, R., Hasan, N. F., Refaie, R., Mostafa, S. M., Mohamed, A. A., Khalil, M., Elagawy, W., & Abd-Elsalam, S. (2020). Relationship Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease (NAFLD) in a Developing Country: A Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 619-625.
https://doi.org/10.2147/dmso.s237866
7. Mantovani, A., Turino, T., Altomari, A., Lonardo, A., Zoppini, G., Valenti, L., Tilg, H., Byrne, C. D., & Targher, G. (2019). Association between Helicobacter pylori infection and risk of nonalcoholic fatty liver disease: An updated meta-analysis. Metabolism, 96, 56-65.
https://doi.org/10.1016/j.metabol.2019.04.012
8. Ning, L., Liu, R., Lou, X., Du, H., Chen, W., Zhang, F., Li, S., Chen, X., & Xu, G. (2019). Association between Helicobacter pylori infection and nonalcoholic fatty liver disease: A systemic review and meta-analysis. European Journal of Gastroenterology & Hepatology, 31(7), 735-742.
https://doi.org/10.1097/meg.0000000000001398
9. Xu, G., Ma, S., Dong, L., Mendez-Sanchez, N., Li, H., & Qi, X. (2023). Relationship of Helicobacter pylori infection with nonalcoholic fatty liver disease: A meta-analysis. Canadian Journal of Gastroenterology and Hepatology, 2023, 1-13.
https://doi.org/10.1155/2023/5521239
10. Baryshnikova, N. V., Ermolenko, E. I., Leontieva, G. F., Uspenskiy, Y. P., & Suvorov, A. N. (2024). Helicobacter pylori infection and metabolic syndrome. Exploration of Digestive Diseases, 414-427.
11. https://doi.org/10.37349/edd.2024.00058
12. Nigatie, M., Melak, T., Asmelash, D., & Worede, A. (2022). Dyslipidemia and its associated factors among Helicobacter pylori-infected patients attending at University of Gondar comprehensive specialized hospital, Gondar, north-west Ethiopia: A comparative cross-sectional study. Journal of Multidisciplinary Healthcare, 15, 1481-1491.
https://doi.org/10.2147/jmdh.s368832
13. Martin-Nuñez, G. M., Cornejo-Pareja, I., Clemente-Postigo, M., & Tinahones, F. J. (2021). Gut microbiota: The missing link between Helicobacter pylori infection and metabolic disorders? Frontiers in Endocrinology, 12.
https://doi.org/10.3389/fendo.2021.639856
14. Shabalala, S. C., Dludla, P. V., Mabasa, L., Kappo, A. P., Basson, A. K., Pheiffer, C., & Johnson, R. (2020). The effect of adiponectin in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and the potential role of polyphenols in the modulation of adiponectin signaling. Biomedicine & Pharmacotherapy, 131, 110785.
https://doi.org/10.1016/j.biopha.2020.110785
15. Kato, M., Toda, A., Yamamoto‐Honda, R., Arase, Y., & Sone, H. (2019). Association between Helicobacter pylori infection, eradication and diabetes mellitus. Journal of Diabetes Investigation, 10(5), 1341-1346.
https://doi.org/10.1111/jdi.13011
16. Liu, Y., Xu, H., Zhao, Z., Dong, Y., Wang, X., & Niu, J. (2022). No evidence for a causal link between Helicobacter pylori infection and nonalcoholic fatty liver disease: A bidirectional mendelian randomization study. Frontiers in Microbiology, 13.
https://doi.org/10.3389/fmicb.2022.1018322
17. Liu, C., Wu, Q., Ren, R., Zhang, Z., Shi, Y., & Li, H. (2023). Helicobacter pylori infection increases the risk of nonalcoholic fatty liver disease: Possible relationship from an updated meta-analysis. Medicine, 102(33), e34605.
https://doi.org/10.1097/md.0000000000034605
18. Kim, J. Y., Kwan, B. S., Cho, J. H., Kim, H. I., Ko, N. G., Jin, M., & Lee, O. J. (2025). Persistently active Helicobacter pylori infection is associated with the development of metabolic dysfunction-associated Steatotic liver disease. Journal of Clinical Medicine, 14(4), 1073.
https://doi.org/10.3390/jcm14041073
19. Suzuki, H., & Hirai, M. (2024). Helicobacter pylori infection and oxidative stress. Journal of Clinical Biochemistry and Nutrition. Journal of Clinical Biochemistry and Nutrition, 75(3), 178-182.
https://doi.org/10.3164/jcbn.24-109
20. Ye, J., Feng, T., Su, L., Li, J., Gong, Y., & Ma, X. (2023). Interactions between Helicobacter pylori infection and host metabolic homeostasis: A comprehensive review. Helicobacter, 28(6).
https://doi.org/10.1111/hel.13030
21. An, L., Wirth, U., Koch, D., Schirren, M., Drefs, M., Koliogiannis, D., Nieß, H., Andrassy, J., Guba, M., Bazhin, A. V., Werner, J., & Kühn, F. (2022). The role of gut-derived Lipopolysaccharides and the intestinal barrier in fatty liver diseases. Journal of Gastrointestinal Surgery, 26(3), 671-683.
https://doi.org/10.1007/s11605-021-05188-7
22. Chen, H., Wang, Y., Shao, Y., Su, W., Li, S., Liu, Y., & Zhou, X. (2025). Multi‐Omics Analysis Revealed Characterization of Gastric Microbiome and Metabolome in Helicobacter pylori‐Induced Progression of MASLD. Helicobacter, 30(5).
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