title: Helicobacter pylori infection in patients with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  Clinical data regarding Helicobacter pylori (Hp) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was the evaluation of Hp infection in patients with NAFLD and its association with disease severity.
  
  
  METHODS
  28 patients with biopsy-proven NAFLD (15 with simple nonalcoholic fatty liver [NAFL], 13 with nonalcoholic steatohepatitis [NASH]) and 25 matched healthy controls were recruited. Blood samples for anti-Hp Immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting, and (13)C urea breath test was performed before liver biopsy in NAFLD group.
  
  
  RESULTS
  Higher rates of anti-Hp IgG (P=.038) were observed in NAFLD compared to control group. Only two NAFLD patients neither were Hp IgG seropositive nor did they have a history of eradication treatment compared to 11 control subjects (P=.002). Both Hp infection (assessed by history of Hp eradication treatment and/or Hp IgG seropositivity) (P=.034) and log(HOMA-IR) (P=.007) could independently predict NAFLD in logistic regression analysis. There were similar rates of Hp IgG seropositivity or positivity in (13)C urea breath test or their combination between NAFL and NASH patients. There were no significant differences in steatosis grade, fibrosis stage, lobular or portal inflammation, or ballooning, when NAFLD patients were divided according to Hp IgG seropositivity or (13)C urea breath test positivity.
  
  
  CONCLUSIONS
  Hp infection may represent one more hit contributing to the pathogenesis of NAFL, though not to the progression from NAFL to NASH. These results warrant further validation. If confirmed, eradicating Hp infection may have certain therapeutic perspectives in NAFLD treatment.
authors: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece. stergios@endo.gr
authors: Stergios A
authors: SA
authors: Polyzos
authors: Jannis
authors: J
authors: Kountouras
authors: Athanasios
authors: A
authors: Papatheodorou
authors: Kalliopi
authors: K
authors: Patsiaoura
authors: Evangelia
authors: E
authors: Katsiki
authors: Efthimia
authors: E
authors: Zafeiriadou
authors: Christos
authors: C
authors: Zavos
authors: Kyriaki
authors: K
authors: Anastasiadou
authors: Evangelos
authors: E
authors: Terpos
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000382:microbiology* / Q000473:pathology; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000378:metabolism* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D007074:Immunoglobulin G; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase