Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan

Abstract

BackgroundFatty liver disease (FLD) including non-alcoholic fatty liver disease (NAFLD), a rapidly emerging and widely recognized liver disease today, is regarded as a hepatic manifestation of metabolic syndrome. Helicobacter pylori, one of the most common pathogens worldwide, has been reported to be associated with metabolic syndrome, but whether there is a direct association with FLD is as of yet unclear. The aim of this study was to clarify the association of FLD and NAFLD with causative background factors including Helicobacter pylori infection.MethodsThis was a cross-sectional study of Japanese adults who received medical checkups at a single medical center in 2010.Univariate and multivariate statistical analysis was performed to evaluate background factors for ultrasonography diagnosed FLD. Subjects free from alcohol influence were similarly analyzed for NAFLD.ResultsOf a total of 13,737 subjects, FLD was detected in 1,456 of 6,318 females (23.0 %) and 3,498 of 7,419 males (47.1%). Multivariable analyses revealed that body mass index (standardized coefficients of females and males (β-F/M) =143.5/102.5), serum ALT (β-F/M = 25.8/75.7), age (β-F/M = 34.3/17.2), and platelet count (β-F/M = 17.8/15.2) were positively associated with FLD in both genders. Of the 5,289 subjects free from alcohol influence, NAFLD was detected in 881 of 3,473 females (25.4%) and 921 of 1,816 males (50.7%). Body mass index (β-F/M = 113.3/55.3), serum ALT (β-F/M = 21.6/53.8), and platelet count (β-F/M = 13.8/11.8) were positively associated with NAFLD in both genders. Metabolic syndrome was positively associated with FLD and NAFLD only in males. In contrast, Helicobacter pylori infection status was neither associated with FLD nor NAFLD regardless of gender.ConclusionsBody mass index, serum ALT and platelet count were significantly associated with FLD and NAFLD, whereas infection of Helicobacter pylori was not.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0247-9) contains supplementary material, which is available to authorized users.

The Role of Morbid Obesity in the Promotion of Metabolic Disruptions and Non-Alcoholic Steatohepatitis by Helicobacter Pylori

“…In addition, an unexpected finding was observed in those individuals with NAFLD: obese patients with histologic positivity for HP showed higher degrees of liver steatosis and lower prevalence of NASH than subjects without HP infection. Our results are in concordance with those observed in a large-scale cross-sectional study performed with Japanese adults in whom body mass index, platelet count, and serum ALT, but not HP infection, were positively associated with NAFLD diagnosed based on ultrasound methodology [40]. As imaging has limited diagnostic value for NAFLD, the prediction of fatty liver has been investigated through various surrogate scores, including the fatty liver index (FLI), and the hepatic steatosis index (HSI) in general population [41, 42].…”

Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis

“…Serum anti-H. pylori IgG, serum pepsinogen I and II, and other factors Serum anti-H. pylori IgG and pepsinogens were measured using commercial kits (E-plate; EIKEN, Tokyo, Japan) [26][27][28][29][30]. According to the manufacturer's instructions, a titer of anti-H. pylori IgG C10 U/ml was considered as positive for H. pylori infection.…”

Helicobacter pylori and non‐alcoholic fatty liver disease: A new enigma?

“…5 In spite of the fact that H. pylori is an etiology of many gut disorders, recent papers reported its role in metabolic diseases involving NAFLD. [9][10][11][12] Therefore, we carried out this prospective screening work of asymptomatic healthy participants to study whether H. pylori infection is a potential risk factor for NAFLD. [6][7][8] Notwithstanding, clinical studies linking NAFLD with H. pylori are limited, because many studies depend on serological tests to diagnose H. pylori and small sample size.…”