title: Helicobacter pylori infection might have a potential role in hepatocyte ballooning in nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Clinical data regarding Helicobacter pylori (H. pylori) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was to evaluate H. pylori infection in patients with NAFLD and its association with disease severity.
  
  
  METHODS
  One hundred and thirty patients with biopsy-proven NAFLD [43 with nonalcoholic fatty liver (NAFL) and 87 with nonalcoholic steatohepatitis (NASH)] were recruited for blood samples for anti-H. pylori immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting. Glucose tolerance was evaluated by 75-g oral glucose tolerance test. Liver biopsies were scored for NAFLD activity score (NAS), fibrosis and iron deposits.
  
  
  RESULTS
  H. pylori IgG seropositivity was found in 40 % of patients overall. The prevalence of NASH was significantly higher in the patients with H. pylori IgG seropositivity (81 %) than in those without (58 %, p = 0.008). Glucose intolerance was similar between the two groups. The total NAS and the grade of hepatocyte ballooning were higher in the patients with H. pylori IgG seropositivity than in those without, while the hepatic iron grade was lower in the patients with H. pylori IgG seropositivity than in those without. H. pylori infection (p = 0.030), female gender (p = 0.029), and NAFIC score ≥ 2 points (p < 0.001) could independently predict NASH in logistic regression analysis, independent of age, obesity and glucose tolerance.
  
  
  CONCLUSIONS
  The association of H. pylori seropositivity with hepatocyte ballooning suggests that H. pylori infection may represent another contributing factor in the progression from NAFL to NASH. Eradicating H. pylori infection may have therapeutic prospects in NASH treatment.
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan, sumida@koto.kpu-m.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Imai
authors.forename: Kojiro
authors.initials: K
authors.lastname: Mori
authors.forename: Saiyu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hideto
authors.initials: H
authors.lastname: Shimokobe
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Kohei
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Kakutani
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ohno
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Taketani
authors.forename: Yuya
authors.initials: Y
authors.lastname: Seko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishiba
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hara
authors.forename: Akira
authors.initials: A
authors.lastname: Okajima
authors.forename: Kanji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Michihisa
authors.initials: M
authors.lastname: Moriguchi
authors.forename: Hironori
authors.initials: H
authors.lastname: Mitsuyoshi
authors.forename: Kohichiroh
authors.initials: K
authors.lastname: Yasui
authors.forename: Masahito
authors.initials: M
authors.lastname: Minami
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test; D016481:Helicobacter Infections / Q000097:blood / Q000382:microbiology*; D016480:Helicobacter pylori / Q000276:immunology*; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000382:microbiology*
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G