Introduction Helicobacter pylori infection has been implicated in the pathogenesis of various gastrointestinal, hematologic, and systemic diseases. Association between Helicobacter pylori infection and nonalcoholic fatty liver disease (NAFLD) is poorly characterised. The aim of this study was to investigate the association between H. pylori positivity with cagA status and NAFLD in the large general population.
Methods The Third National Health and Nutrition Examination Survey (NHANES) from 1988 to 1994 was utilised in this study. NAFLD was defined by ultrasonographic detection of hepatic steatosis without other known liver diseases. Antibodies to H. pylori and cagA of participants 20 years and older were measured in using ELISA.
Results Among total of 5,404 participants who had results of both ultrasonography and H. pylori serology, the prevalence of NAFLD was 31.9%. The prevalence of NAFLD was higher in H. pylori positive subjects (33.5±1.79%) than in negative subjects (26.1±1.65%, p < 0.001). Compared with cagA positive group, participants with negative cagA had higher prevalence of NAFLD (31.1±2.30% vs. 36.4±2.37%, p < 0.001). Overall participants with NAFLD had higher prevalence of H. pylori positivity in multivariable analysis (Odds ratio [OR]: 1.17; 95% confidence interval [CI]: 0.95–1.43) with marginal significance. With regard to presence of cagA protein, H. pylori and cagA positivity was not associated with NAFLD (OR: 1.05; 95% CI: 0.81–1.37) but, cagA negative H. pylori positivity was significantly associated with NAFLD in multivariable analysis (OR: 1.30; 95% CI: 1.01–1.67).
Conclusion The prevalence of NAFLD was higher in H. pylori positive subjects than in negative subjects. Especially, cagA negative H. pylori positivity was significantly associated with NAFLD, independent of other known factors in the general population.
References 1 Ong JP, Younossi ZM. Epidemiology and natural history of NAFLD and NASH. Clin Liver Dis 2007;11:1–16, vii.
2 Kim D, Kim WR, Kim HJ, Therneau TM. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology 2013;57:1357–65.
3 Chung GE, Kim D, Kim W, et al. Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. J Hepatol 2012;57:150–6.
Disclosure of Interest None Declared