Research Article
Volume 7 Issue 3 - 2020
Prevalence of Helicobacter pylori Infection in Nondiabetic NAFLD and its Association in the Severity of Fibrosis
Warisara Siricharoonwong* and Rattana Boonsirichan
Division of Gastroenterology, Department of Internal Medicines, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
*Corresponding Author: Warisara Siricharoonwong, Division of Gastroenterology, Department of Internal Medicines, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Received: December 09, 2019; Published: February 06, 2020




Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of cirrhosis worldwide. A considerable amount of patients without DM still has NASH and advanced fibrosis. Helicobacter pylori (H. pylori) infection contribute to the increase in levels of pro-inflammatory cytokines which have different metabolic effects and associated with insulin resistance (IR). Therefore, H. pylori may possibly have an effect on fibrosis progression in NAFLD in nondiabetic patients.

Objectives: Our study aims to investigate the prevalence of H. pylori infection in non-diabetic NAFLD patient and its association in advance fibrosis.

Method: Nondiabetic patients who were diagnosed NAFLD by abdominal ultrasonography and/or controlled attenuation parameter (CAP) from FibroScan® were recruited for H. pylori infection testing by a 14C-urea breath test. All participants were evaluated liver fibrosis with transient elastography. They were collected standard biochemical test (e.g. FPG, LDL, liver function test) and interleukin-6 to evaluate the inflammatory response. To minimized the confounding effect, we excluded patients who had BMI > 28 kg/m2 or received steatogenic drugs. The outcome was the prevalence of H. pylori infection in NAFLD patients. We also investigated factors which independently associated with advanced fibrosis.

Result: A total of 117 NAFLD patients were enrolled. We found overall H. pylori infection in 54 patients (46%). In patients with advanced fibrosis (defined as fibrosis stage ≥ 3 from transient elastography), the prevalence of advanced hepatic fibrosis in NAFLD patients with H. pylori infection is higher (22/54, 40.7%) than in non-infected group (18/63, 28.6%). Obesity was the variable most associated with advanced fibrosis (OR 3.18 [1.25 - 8.09], p-value 0.02) in univariate analysis. H. pylori infection had a marginal effect to advanced fibrosis (OR 1.72 [0.8 - 3.71], p-value 0.17) but no statistically significant in multivariate analysis. Other metabolic variables and interleukin-6 were not significantly associated with advanced fibrosis.

Conclusion: Prevalence of H. pylori infection in nondiabetic NAFLD patient similar to the general Thai population. Our results could not demonstrate the risk of H. pylori infection to advanced fibrosis. However, NAFLD patients with H. pylori infection tend to have a higher prevalence of advance hepatic fibrosis.

Keywords: Nonalcoholic Fatty Liver Disease (NAFLD); Nonalcoholic Fatty Liver (NAFL); Nonalcoholic Steatohepatitis (NASH); Liver Cirrhosis (LC); Helicobacter pylori (H. pylori)

References

  1. Li M., et al. “Potential role of Helicobacter pylori infection in nonalcoholic fatty liver disease”. World journal of gastroenterology 19.41 (2013): 7024-7031.
  2. Wijarnpreecha K., et al. “Helicobacter pylori and Risk of Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis”. Journal of Clinical Gastroenterology (2017).
  3. Goh GB., et al. “Clinical spectrum of non-alcoholic fatty liver disease in diabetic and non-diabetic patients”. Biochimica et Biophysica Acta Clinical 3 (2015): 141-145.
  4. Stal P. “Liver fibrosis in non-alcoholic fatty liver disease - diagnostic challenge with prognostic significance”. World Journal of Gastroenterology 21.39 (2015): 11077-11087.
  5. Buzas GM. “Metabolic consequences of Helicobacter pylori infection and eradication”. World Journal of Gastroenterology 20.18 (2014): 5226-5234.
  6. Kim TJ., et al. “A cohort study on Helicobacter pylori infection associated with nonalcoholic fatty liver disease”. Journal of Gastroenterology (2017).
  7. Tang DM and Kumar S. “The Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease”. Current Gastroenterology Reports 19.2 (2017): 5.
  8. Sumida Y., et al. “Helicobacter pylori infection might have a potential role in hepatocyte ballooning in nonalcoholic fatty liver disease”. Journal of Gastroenterology 50.9 (2015): 996-1004.
  9. Ponzetto A., et al. “Helicobacter infection and cirrhosis in hepatitis C virus carriage: is it an innocent bystander or a troublemaker?”. Medical Hypotheses 54.2 (2000): 275-277.
  10. Esmat G., et al. “Role of Helicobacter pylori in patients with HCV-related chronic hepatitis and cirrhosis with or without hepatocellular carcinoma: possible association with disease progression”. Journal of Viral Hepatitis 19.7 (2012): 473-479.
  11. Wong VW., et al. “Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter”. Journal of Hepatology 67.3 (2017): 577-584.
  12. Treeprasertsuk S., et al. “NAFLD fibrosis score: a prognostic predictor for mortality and liver complications among NAFLD patients”. World Journal of Gastroenterology 19.8 (2013): 1219-1229.
  13. Peleg N., et al. “AST to Platelet Ratio Index and fibrosis 4 calculator scores for non-invasive assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease”. Digestive and Liver Disease 49.10 (2017): 1133-1138.
  14. Mikolasevic I., et al. “Transient elastography (FibroScan((R))) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease - Where do we stand?”. World Journal of Gastroenterology 22.32 (2016): 7236-7251.
  15. Best LMJ TY., et al. “Non-invasive diagnostic tests for infection”. Cochrane Database of Systematic Reviews 3 (2018).
  16. Uchida T., et al. “Helicobacter pylori Infection in Thailand: A Nationwide Study of the CagA Phenotype”. PLoS One 10.9 (2015): e0136775.
  17. Hooi JKY., et al. “Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis”. Gastroenterology 153.2 (2017): 420-429.
  18. Kang SJ., et al. “Association between cagA negative Helicobacter pylori status and nonalcoholic fatty liver disease among adults in the United States”. PLoS One 13.8 (2018): e0202325.
  19. Okushin K., et al. “Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan”. BMC Gastroenterology 15 (2015): 25.
  20. Goo MJ.,et al. “Helicobacter pylori promotes hepatic fibrosis in the animal model”. Laboratory Investigation a Journal of Technical Methods and Pathology 89.11 (2009): 1291-303.
  21. Karlas T., et al. “Impact of controlled attenuation parameter on detecting fibrosis using liver stiffness measurement”. Alimentary Pharmacology and Therapeutics 47.7 (2018): 989-1000.
  22. Nakagawa H., et al. “Significant association between serum interleukin-6 and Helicobacter pylori antibody levels among H. pylori-positive Japanese adults”. Mediators of Inflammation 2013 (2013): 142358.
  23. Das SK and Balakrishnan V. “Role of cytokines in the pathogenesis of non-alcoholic Fatty liver disease”. Indian Journal of Clinical Biochemistry 26.2 (2011): 202-209.
Citation: Warisara Siricharoonwong and Rattana Boonsirichan. “Prevalence of Helicobacter pylori Infection in Nondiabetic NAFLD and its Association in the Severity of Fibrosis”. EC Gastroenterology and Digestive System 7.3 (2020): 01-09.

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