title: Association between Helicobacter pylori and liver-to-spleen ratio:  a randomized-controlled single-blind study.
abstract: OBJECTIVE
  Helicobacter pylori infection is reported to be associated with some extragastrointestinal manifestations, such as hematological diseases (thrombocytopenia, anemia), obesity, and fatty liver disease. The length or the volume ratio of liver to spleen was suggested to be changed in some hematological and hepatobiliary disorders. We hypothesized that the liver-to-spleen ratio may be affected in H. pylori-positive patients. In this respect, we aimed to evaluate the effect of H. pylori infection on the liver-to-spleen ratio and platelet indices.
  
  
  METHODS
  A total of 174 patients with functional dyspepsia were included in the study. Patients were divided into group 1 (H. pylori-positive gastritis) (n=95) and group 2 (H. pylori negative, control group) (n=79). Liver, spleen length measurement, and liver steatosis scores were performed by ultrasonography by the same physicians who were blinded to the H. pylori results. Blood count values including the platelet count and the mean platelet volume (MPV) were compared between the two groups. BMI was also evaluated as a potential confounding factor for fatty liver.
  
  
  RESULTS
  The liver-to-spleen ratio, platelet-to-spleen ratio, MPV-to-spleen ratio, and the MPV-to-liver ratio were significantly lower in the H. pylori-positive group compared with the H. pylori-negative group (P<0.001, <0.001, <0.001, and 0.038, respectively). Fatty liver was significantly more frequent in H. pylori-positive patients.
  
  
  CONCLUSIONS
  Liver-to-spleen ratio and the MPV-to-spleen ratio are important indices in the pathogenesis of H. pylori-linked liver and spleen manifestations, and thrombocytopenia.
authors.affiliation: Ankara Education and Research Hospital, Ankara, Turkey. doganzeynal@yahoo.com
authors.forename: Zeynal
authors.initials: Z
authors.lastname: Doğan
authors.forename: Levent
authors.initials: L
authors.lastname: Filik
authors.forename: Bilal
authors.initials: B
authors.lastname: Ergül
authors.forename: Murat
authors.initials: M
authors.lastname: Sarikaya
authors.forename: Erdem
authors.initials: E
authors.lastname: Akbal
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D016145:Endoscopy, Digestive System; D005234:Fatty Liver / Q000097:blood / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D010976:Platelet Count; D012307:Risk Factors; D016037:Single-Blind Method; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D013921:Thrombocytopenia / Q000097:blood / Q000382:microbiology* / Q000473:pathology; D014421:Turkey; D014463:Ultrasonography