title: The Role of Morbid Obesity in the Promotion of Metabolic Disruptions and Non-Alcoholic Steatohepatitis by Helicobacter Pylori.
abstract: BACKGROUND
  Helicobacter pylory (HP) infection has been associated to an increased rate of type 2 diabetes (T2D) and liver disease through its effect on insulin resistance and systemic inflammation. However, results are inconstant and no studies exist in morbidly obese patients, in which both insulin resistance and inflammation coexist.
  
  
  METHODS
  Cross-sectional study to evaluate the relationship between HP infection and alterations in carbohydrate metabolism, lipid profile, inflammation markers, and liver disease in patients awaiting for bariatric surgery. HP infection was histologically assessed in gastric antrum biopsy from 416 subjects. Liver biopsy was also available in 93 subjects.
  
  
  RESULTS
  Both impaired fasting glucose and T2D were similar when comparing subjects with and without HP infection (24.2% vs. 22%, p = 0.290 and 29.4% vs. 29.1%, p = 0.916, respectively), with no differences between groups in the HOMA-IR, lipid profile neither inflammatory parameters. However, HP infection was higher among subjects with a BMI ≥ 40.0 kg/m2 in comparison with lower degrees of obesity (71.7% vs. 60.0%, p = 0.041). In addition, subjects without HP infection showed higher degrees of steatosis (44.1±26.4% vs. 32.0±20.7%, p = 0.038), as well as a lower prevalence of non-alcoholic steatohepatitis (9.3% vs. 30.7%, p = 0.023).
  
  
  CONCLUSIONS
  In patients with morbid obesity, HP infection does not seem to be associated with abnormal carbohydrate metabolism. In addition, less advanced degrees of non-alcoholic fatty disease were observed. We suggest that low-grade inflammation that accompanies obesity mitigates the diabetogenic effect of HP, so the presence of obesity should be considered in studies that evaluate the HP metabolic effects.
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.|CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBEREM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
authors.forename: Albert
authors.identifier: http://orcid.org/0000-0001-9684-0183
authors.initials: A
authors.lastname: Lecube
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Valladares
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: López-Cano
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Liliana
authors.initials: L
authors.lastname: Gutiérrez
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Andreea
authors.initials: A
authors.lastname: Ciudin
authors.affiliation: Endocrine, Bariatric and Metabolic Surgery Unit, IFSO Centre of Excellence, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Fort
authors.affiliation: Gastroenterology Department. Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Reñé
authors.affiliation: Department of Pathology and Molecular Genetics, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Matias-Guiu
authors.affiliation: Pathology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: de Torres
authors.affiliation: Endocrinology and Nutrition Department, EASO Collaborating Centre for Obesity Management, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Bueno
authors.affiliation: Department of Pathology and Molecular Genetics, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Pallarés
authors.affiliation: Gastrointestinal Surgery Department. Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica (IRB) and University of Lleida, Lleida, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Baena
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D050260:Carbohydrate Metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D009767:Obesity, Morbid / Q000453:epidemiology / Q000378:metabolism* / Q000382:microbiology
chemical_list: D001786:Blood Glucose