title: Helicobacter pylori infection is not associated with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  To determine whether Helicobacter pylori (H. pylori) infection confers a higher risk of Nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  Healthy people who underwent health screening were analyzed retrospectively. Inclusion criteria were age ≥ 20 years, history of H. pylori infection, and recorded insulin level. Participants were classified as H. pylori positive or negative according to (13)C urea breath tests. NAFLD was defined using the hepatic steatosis index (HSI) and NAFLD liver fat score (NAFLD-LFS). Those with an HSI > 36 or NAFLD-LFS > -0.640 were considered to have NAFLD. Multivariable logistic regression was performed to identify risk factors for NAFLD.
  
  
  RESULTS
  Three thousand six hundred and sixty-three people were analyzed and 1636 (44.7%) were H. pylori positive. H. pylori infection was associated with older age, male gender, hypertension, higher body mass index, and a dyslipidemic profile. HSI differed significantly between H. pylori positive and negative subjects (median 33.2, interquartile range (IQR) 30.0-36.2 for H. pylori-positive vs median 32.6, IQR 29.8-36.0 for negative participants, P = 0.005), but NAFLD-LSF did not [median -1.7, IQR -2.4 - -0.7 vs median -1.8, IQR -2.4-(-0.7), respectively, P = 0.122]. The percentage of people with NAFLD did not differ between infected and uninfected groups: HIS, 26.9% vs 27.1%, P = 0.173; NAFLD-LFS, 23.5% vs 23.1%, P = 0.778. H. pylori infection was not a risk factor, but C-reactive protein concentration and smoking were significant risk factors for NAFLD.
  
  
  CONCLUSIONS
  H. pylori infection is not a risk factor for NAFLD as indicated by HSI or NAFLD-LFS. Prospective, large-scale studies involving liver biopsies should be considered.
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Myong Ki
authors.initials: MK
authors.lastname: Baeg
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Sun-Hye
authors.initials: SH
authors.lastname: Ko
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Yong-Sun
authors.initials: YS
authors.lastname: Noh
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: In-Seok
authors.initials: IS
authors.lastname: Lee
authors.affiliation: Myong Ki Baeg, Seung Kew Yoon, Sun-Hye Ko, Yong-Sun Noh, In-Seok Lee, Myung-Gyu Choi, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Helicobacter pylori; Hepatic steatosis index; Nonalcoholic fatty liver disease; Nonalcoholic fatty liver disease liver fat score; Urea breath test