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


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)


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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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