Diabetes, Metabolic Syndrome and Obesity (Mar 2020)
Relationship Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease (NAFLD) in a Developing Country: A Cross-Sectional Study
Abstract
Yousry Esam-Eldin Abo-Amer, 1 Aisha Sabal, 2 Rehab Ahmed, 2 Nabil Fathy Esmael Hasan, 3 Rasha Refaie, 4 Sahar Mohamed Mostafa, 2 Ahmed Abdelhaleem Mohamed, 2 Mahmoud Khalil, 2 Waleed Elagawy, 5 Sherief Abd-Elsalam 6 1Hepatology, Gastroenterology and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Gharbia, Egypt; 2Hepatology, Tropical Medicine and Infectious Diseases Departments, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 3Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 4Internal Medicine Department, Helwan University, Helwan, Egypt; 5Department of Tropical Medicine, Portsaid University, Portsaid, Egypt; 6Tropical Medicine Department, Tanta University, Tanta, EgyptCorrespondence: Sherief Abd-ElsalamTropical Medicine Department, Tanta University, Tanta, EgyptTel +201063319696Email [email protected]: Non-alcoholic fatty liver disease (NAFLD) is a very common disease that affects 25– 30% of the population in western countries. Many studies have observed the importance of H. pylori infection in the development of insulin resistance, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, and liver fibrosis and cirrhosis. However, the evidence from different studies was controversial. The present study aimed to investigate the relationship between H. pylori infection and NAFLD in a developing country.Patients and Methods: This cross-sectional study included all the attending outpatient clinics at four Major University hospitals and two research and clinical institutes in a developing country in the period between June and October 2019. Patients were assessed for the diagnosis of H. pylori infection as detected by H. pylori antigen in stool; they were also assessed for the diagnosis of NAFLD by ultrasound, fibroscan, and CAP.Results: The study was conducted on 646 patients; H. pylori infection was found to be present in 538 patients (83.3%). NAFLD (diagnosed by both U/S and Fibroscan with CAP), ALT, AST, hepatomegaly, hypertension, fasting blood sugar were significantly higher in H. pylori +ve group than H. pylori −ve group. After performing Linear regression of independent risk factors of NAFLD to prove or to refute the role of Helicobacter; H. pylori positivity, total cholesterol, degree of fatty liver by ultrasound, fasting blood sugar and diastolic blood pressure were independent risk factors for NAFLD.Conclusion: Helicobacter pylori infection was independent risk factors for NAFLD and correlated with increased degree of steatosis.Keywords: Helicobacter pylori, steatosis, fibrosis, NAFLD, prevalence, fibroscan
