title: Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan.
abstract: BACKGROUND
  Fatty liver disease (FLD) including non-alcoholic fatty liver disease (NAFLD), a rapidly emerging and widely recognized liver disease today, is regarded as a hepatic manifestation of metabolic syndrome. Helicobacter pylori, one of the most common pathogens worldwide, has been reported to be associated with metabolic syndrome, but whether there is a direct association with FLD is as of yet unclear. The aim of this study was to clarify the association of FLD and NAFLD with causative background factors including Helicobacter pylori infection.
  
  
  METHODS
  This was a cross-sectional study of Japanese adults who received medical checkups at a single medical center in 2010.Univariate and multivariate statistical analysis was performed to evaluate background factors for ultrasonography diagnosed FLD. Subjects free from alcohol influence were similarly analyzed for NAFLD.
  
  
  RESULTS
  Of a total of 13,737 subjects, FLD was detected in 1,456 of 6,318 females (23.0 %) and 3,498 of 7,419 males (47.1%). Multivariable analyses revealed that body mass index (standardized coefficients of females and males (β-F/M) =143.5/102.5), serum ALT (β-F/M = 25.8/75.7), age (β-F/M = 34.3/17.2), and platelet count (β-F/M = 17.8/15.2) were positively associated with FLD in both genders. Of the 5,289 subjects free from alcohol influence, NAFLD was detected in 881 of 3,473 females (25.4%) and 921 of 1,816 males (50.7%). Body mass index (β-F/M = 113.3/55.3), serum ALT (β-F/M = 21.6/53.8), and platelet count (β-F/M = 13.8/11.8) were positively associated with NAFLD in both genders. Metabolic syndrome was positively associated with FLD and NAFLD only in males. In contrast, Helicobacter pylori infection status was neither associated with FLD nor NAFLD regardless of gender.
  
  
  CONCLUSIONS
  Body mass index, serum ALT and platelet count were significantly associated with FLD and NAFLD, whereas infection of Helicobacter pylori was not.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. koxin-tky@umin.org.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Okushin
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. yutakahashi-tky@umin.ac.jp.
authors.forename: Yu
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. nyamamic-tky@umin.ac.jp.
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.affiliation: Kameda Medical Center Makuhari (CD-2, 1-3, Nakase, Mihama-ku, Chiba-city, Japan. tshimamoto@gmail.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. enooku.tky@gmail.com.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Enooku
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. fujinaga-tky@umin.net.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Fujinaga
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. tsutsumi-tky@umin.ac.jp.
authors.forename: Takeya
authors.initials: T
authors.lastname: Tsutsumi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. shintani-tky@umin.ac.jp.
authors.forename: Yoshizumi
authors.initials: Y
authors.lastname: Shintani
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. ysakaguchi0116@yahoo.co.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sakaguchi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. satoshi-tky@umin.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. kodashima-tky@umin.ac.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. moriya-tky@umin.ac.jp.
authors.forename: Kyoji
authors.initials: K
authors.lastname: Moriya
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. hyotsu-tky@umin.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yotsuyanagi
authors.affiliation: Kameda Medical Center Makuhari (CD-2, 1-3, Nakase, Mihama-ku, Chiba-city, Japan. ToruMitsushima@yahoo.co.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsushima
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. kkoike-tky@umin.ac.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D010976:Platelet Count; D012737:Sex Factors; D014463:Ultrasonography
chemical_list: D000410:Alanine Transaminase