Associations of Helicobacter pylori infection with NAFLD, MAFLD, MASLD, and Chinese MAFLD.

BACKGROUND

The association of Helicobacter pylori (H. pylori) infection with non-alcoholic fatty liver disease (NAFLD) remains controversial. Additionally, its associations with metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), and Chinese MAFLD using the most recent diagnostic criteria were unclear.

OBJECTIVE

To analyze the associations of H. pylori infection with NAFLD, MAFLD, MASLD, and Chinese MAFLD.

DESIGN

Cross-sectional study.

METHODS

This study screened 1172 inpatients who underwent both H. pylori test and liver computed tomography or ultrasound examination between June 2020 and May 2024. Multivariate Logistic regression analyses were performed to evaluate the associations of H. pylori infection with the severity of hepatic steatosis and risk of hepatic fibrosis. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated after adjusting for gender, hypertension, hyperlipidemia, body mass index (BMI), fasting plasma glucose (FPG), and high-sensitivity C-reactive protein (HsCRP) in NAFLD analyses; age, gender, drinking, hypertension, diabetes, hyperlipidemia, BMI, and HsCRP in MAFLD analyses; and gender, drinking, hypertension, hyperlipidemia, BMI, FPG, and HsCRP in MASLD and Chinese MAFLD analyses.

RESULTS

Overall, 875, 982, 869, and 869 patients were included in NAFLD, MAFLD, MASLD, and Chinese MAFLD analyses, respectively. In NAFLD, MAFLD, MASLD, and Chinese MAFLD analyses, 257, 302, 257, and 257 patients had H. pylori infection, respectively. H. pylori infection was independently associated with severe hepatic steatosis in NAFLD (aOR = 3.956; 95% CI = 1.171-13.359, p = 0.027), MAFLD (aOR = 3.730; 95% CI = 1.083-12.850, p = 0.037), and MASLD (aOR = 3.962; 95% CI = 1.158-13.557, p = 0.028) analyses, but not Chinese MAFLD analyses. However, H. pylori infection was not independently associated with the risk of hepatic fibrosis.

CONCLUSION

H. pylori infection may increase the severity of NAFLD, MAFLD, and MASLD, but not the risk of liver fibrosis.