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A cohort study on Helicobacter pylori infection associated with nonalcoholic fatty liver disease.
J Gastroenterol. 2017 Nov; 52(11):1201-1210.JG

Abstract

BACKGROUND

Previous studies have suggested a link between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD), yet large-scale longitudinal studies are lacking to elucidate this association.

METHODS

A cohort study of 17,028 adults without NAFLD at baseline, who participated in a repeated health screening examination including an H. pylori-specific immunoglobulin G antibody test, was conducted to evaluate the association between H. pylori and NAFLD development. Fatty liver was diagnosed by ultrasonography.

RESULTS

During the 83,130 person-years follow-up, participants with H. pylori infection had a higher rate of incident NAFLD than those who were uninfected. In a multivariable model adjusted for age, sex, body mass index, smoking status, alcohol intake, regular exercise, year of screening exam, and education level, the hazard ratio (HR) for NAFLD development in participants with H. pylori infection compared to those without infection was 1.21 [95% confidence interval (CI), 1.10-1.34]. The association persisted after further adjustment for metabolic variables, inflammatory marker, and liver enzymes. The association between H. pylori and NAFLD was still evident in an analysis using fatty liver index as a surrogate marker of NAFLD. In addition, the association between H. pylori infection and incident NAFLD did not differ across clinically relevant subgroups evaluated.

CONCLUSIONS

H. pylori infection was significantly associated with the development of NAFLD, independent of metabolic and inflammatory risk factors. H. pylori infection may play a pathophysiologic role in NAFLD development, indicating that H. pylori eradication might play a role in reducing the risk of NAFLD.

Authors+Show Affiliations

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 100-742, Republic of Korea. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. leehyuk@skku.edu.Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 100-742, Republic of Korea. sh703.yoo@gmail.com. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. sh703.yoo@gmail.com. Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea. sh703.yoo@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28382402

Citation

Kim, Tae Jun, et al. "A Cohort Study On Helicobacter Pylori Infection Associated With Nonalcoholic Fatty Liver Disease." Journal of Gastroenterology, vol. 52, no. 11, 2017, pp. 1201-1210.
Kim TJ, Sinn DH, Min YW, et al. A cohort study on Helicobacter pylori infection associated with nonalcoholic fatty liver disease. J Gastroenterol. 2017;52(11):1201-1210.
Kim, T. J., Sinn, D. H., Min, Y. W., Son, H. J., Kim, J. J., Chang, Y., Baek, S. Y., Ahn, S. H., Lee, H., & Ryu, S. (2017). A cohort study on Helicobacter pylori infection associated with nonalcoholic fatty liver disease. Journal of Gastroenterology, 52(11), 1201-1210. https://doi.org/10.1007/s00535-017-1337-y
Kim TJ, et al. A Cohort Study On Helicobacter Pylori Infection Associated With Nonalcoholic Fatty Liver Disease. J Gastroenterol. 2017;52(11):1201-1210. PubMed PMID: 28382402.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A cohort study on Helicobacter pylori infection associated with nonalcoholic fatty liver disease. AU - Kim,Tae Jun, AU - Sinn,Dong Hyun, AU - Min,Yang Won, AU - Son,Hee Jung, AU - Kim,Jae J, AU - Chang,Yoosoo, AU - Baek,Sun-Young, AU - Ahn,Soo Hyun, AU - Lee,Hyuk, AU - Ryu,Seungho, Y1 - 2017/04/05/ PY - 2016/12/11/received PY - 2017/03/25/accepted PY - 2017/4/7/pubmed PY - 2018/6/23/medline PY - 2017/4/7/entrez KW - Cohort study KW - Helicobacter pylori KW - Incidence KW - Nonalcoholic fatty liver disease SP - 1201 EP - 1210 JF - Journal of gastroenterology JO - J Gastroenterol VL - 52 IS - 11 N2 - BACKGROUND: Previous studies have suggested a link between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD), yet large-scale longitudinal studies are lacking to elucidate this association. METHODS: A cohort study of 17,028 adults without NAFLD at baseline, who participated in a repeated health screening examination including an H. pylori-specific immunoglobulin G antibody test, was conducted to evaluate the association between H. pylori and NAFLD development. Fatty liver was diagnosed by ultrasonography. RESULTS: During the 83,130 person-years follow-up, participants with H. pylori infection had a higher rate of incident NAFLD than those who were uninfected. In a multivariable model adjusted for age, sex, body mass index, smoking status, alcohol intake, regular exercise, year of screening exam, and education level, the hazard ratio (HR) for NAFLD development in participants with H. pylori infection compared to those without infection was 1.21 [95% confidence interval (CI), 1.10-1.34]. The association persisted after further adjustment for metabolic variables, inflammatory marker, and liver enzymes. The association between H. pylori and NAFLD was still evident in an analysis using fatty liver index as a surrogate marker of NAFLD. In addition, the association between H. pylori infection and incident NAFLD did not differ across clinically relevant subgroups evaluated. CONCLUSIONS: H. pylori infection was significantly associated with the development of NAFLD, independent of metabolic and inflammatory risk factors. H. pylori infection may play a pathophysiologic role in NAFLD development, indicating that H. pylori eradication might play a role in reducing the risk of NAFLD. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/28382402/A_cohort_study_on_Helicobacter_pylori_infection_associated_with_nonalcoholic_fatty_liver_disease_ L2 - https://dx.doi.org/10.1007/s00535-017-1337-y DB - PRIME DP - Unbound Medicine ER -