The Effect of Helicobacter Pylori Eradication on Liver Fat Content in Subjects With Non-Alcoholic Fatty Liver Disease: A Randomized Open-Label Clinical Trial

Abstract

BackgroundThe role of Helicobacter pylori (HP) in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) is unclear.ObjectivesThe aim of this study was to evaluate the effect of HP eradication on liver fat content (LFC), liver function tests (LFT), lipid profile, and homeostasis model assessment-IR (HOMA-IR) index in NAFLD.Patients and MethodsDyspeptic patients with increased serum aminotransferase levels were enrolled in the study. The exclusion criteria were factors affecting serum aminotransferase or HP treatment strategy. Participants with persistent elevated serum aminotransferase level and ultrasound criteria for identification of fatty liver were presumed to have NAFLD. “NAFLD liver fat score” was used to classify NAFLD. Those with “NAFLD liver fat score” greater than -0.64 and positive results for urea breath test (UBT), were included. Lifestyle modification was provided to all participants. HP eradication was performed in intervention arm. LFC, fasting serum glucose (FSG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), triglyceride (TG), cholesterol (CHOL), high and low-density lipoprotein (HDL, LDL), and HOMA-IR were checked at baseline and after that, at intervals of eight weeks and twenty four weeks.ResultsOne hundred (49 males) patients with the mean age of 43.46 (± 11.52) were studied. Repeated measure ANOVA showed a significant reduction in LFC, anthropometric measurements, and laboratory parameters (except for HDL) in the both groups during the study; however, no significant difference was observed between the groups.ConclusionsIt seems that HP eradication per se might not affect LFC, LFT, lipid profile, and insulin resistance in dyspeptic NAFLD patients.

EFFECT OF HELICOBACTER PYLORI ERADICATION ON HEPATIC STEATOSIS, NAFLD FIBROSIS SCORE AND HSENSI IN PATIENTS WITH NONALCOHOLIC STEATOHEPATITIS: a MR imaging-based pilot open-label study

“…Regarding the study's secondary endpoint, anthropometric parameters, blood pressure, liver function tests, lipid profile, ferritin and homocysteine remained essentially unchanged in either group, with the exception of triglycerides, which were paradoxically decreased only in Hp(-) group. Similar to our findings, Jamal et al showed no effect of Hp eradication treatment on lipid profile, insulin resistance, and anthropometric measurements in dyspeptic NAFLD patients, eight and 24 weeks post-treatment (12) . This study has certain limitations.…”

“…Similarly to our findings, Jamali et al reported that Hp eradication treatment had no 8-week and 24-week effect on hepatic fat content of dyspeptic NAFLD patients (12) . Despite similar results, that study was designed differently than ours: 1) hepatic fat content was calculated by the equation proposed by Kotronen et al (the noninvasive index «NΑFLD liver fat score») (14) , whereas directly by MRI in our study; 2) the included patients had ultrasound-proven NAFLD, whereas biopsy-proven NASH in our study; 3) the included patients were dyspeptic, whereas asymptomatic in our study; 4) the control group consisted of Hp(+) patients not assigned to treatment, whereas control group consisted of Hp(-) patients in our study.…”

Protective effect of quercetin on high-fat diet-induced non-alcoholic fatty liver disease in mice is mediated by modulating intestinal microbiota imbalance and related gut-liver axis activation

“…Moreover, we describe for the first time the association between high fat dietinduced NAFLD and enhanced Helicobacter genus detection. Even though is a controversial issue [45,46], it has been suggested the role of Helicobacter pilory as a contributing factor in the progression of NAFLD [47][48][49], considering its eradication as effective preventive or treatment measures [50,51]. Interestingly, Helicobacter genus was dramatically reduced by quercetin treatment in our model of NAFLD, corroborating its anti-Helicobacter activity observed in in vitro and in vivo models of infection [52,53], and supporting therapeutic potential of quercetin for prevention of the spectrum of non-alcoholic fatty liver diseases.…”

Effects of H. pylori infection on carotid intima–media thickness, serum glucose, serum uric acid, liver and kidney function in subjects with chronic alcohol ingestion

“…In addition, H. pylori infection is associated with elevated blood ammonia levels in cirrhotic patients [11]. However, HP eradication per se might not affect liver fat content, liver function tests, lipid profile, and insulin resistance in dyspeptic NAFLD patients [12]. The effects of renal in Hp and alcohol intake are still controversial.…”