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Helicobacter pylori infection might have a potential role in hepatocyte ballooning in nonalcoholic fatty liver disease

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Clinical data regarding Helicobacter pylori (H. pylori) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was to evaluate H. pylori infection in patients with NAFLD and its association with disease severity.

Methods

One hundred and thirty patients with biopsy-proven NAFLD [43 with nonalcoholic fatty liver (NAFL) and 87 with nonalcoholic steatohepatitis (NASH)] were recruited for blood samples for anti-H. pylori immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting. Glucose tolerance was evaluated by 75-g oral glucose tolerance test. Liver biopsies were scored for NAFLD activity score (NAS), fibrosis and iron deposits.

Results

H. pylori IgG seropositivity was found in 40 % of patients overall. The prevalence of NASH was significantly higher in the patients with H. pylori IgG seropositivity (81 %) than in those without (58 %, p = 0.008). Glucose intolerance was similar between the two groups. The total NAS and the grade of hepatocyte ballooning were higher in the patients with H. pylori IgG seropositivity than in those without, while the hepatic iron grade was lower in the patients with H. pylori IgG seropositivity than in those without. H. pylori infection (p = 0.030), female gender (p = 0.029), and NAFIC score ≥ 2 points (p < 0.001) could independently predict NASH in logistic regression analysis, independent of age, obesity and glucose tolerance.

Conclusion

The association of H. pylori seropositivity with hepatocyte ballooning suggests that H. pylori infection may represent another contributing factor in the progression from NAFL to NASH. Eradicating H. pylori infection may have therapeutic prospects in NASH treatment.

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Abbreviations

BMI:

Body mass index

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

NAFL:

Nonalcoholic fatty liver

NAS:

NAFLD activity score

DM:

Diabetes mellitus

H.pylori :

Helicobacter pylori

OGTT:

Oral glucose tolerance test

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Acknowledgments

The authors thank the following individuals for assistance in preparation of this manuscript: Kyoko Sakai, M.D., Ph.D., Saiseikai Suita Hospital, and Kayo Endo, Nara City Hospital.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yoshio Sumida, Hiroyoshi Taketani, Yuya Seko, Hiroshi Ishiba, Tasuku Hara, Akira Okajima, Kanji Yamaguchi, Michihisa Moriguchi, Hironori Mitsuyoshi, Kohichiroh Yasui, Masahito Minami & Yoshito Itoh

  2. Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan

    Kazuyuki Kanemasa, Kojiro Mori, Saiyu Tanaka, Hideto Shimokobe, Yoko Kitamura, Kohei Fukumoto, Akira Kakutani & Tomoyuki Ohno

  3. Department of Pathology, Nara City Hospital, Nara, Japan

    Shunsuke Imai

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  1. Yoshio Sumida
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  2. Kazuyuki Kanemasa
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Correspondence to Yoshio Sumida.

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Sumida, Y., Kanemasa, K., Imai, S. et al. Helicobacter pylori infection might have a potential role in hepatocyte ballooning in nonalcoholic fatty liver disease. J Gastroenterol 50, 996–1004 (2015). https://doi.org/10.1007/s00535-015-1039-2

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  • DOI: https://doi.org/10.1007/s00535-015-1039-2

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