Is Helicobacter pylori infection associated with nonalcoholic fatty liver disease in individuals undergoing bariatric surgery? Cross-sectional study
Keywords:
Helicobacter pylori, Non-alcoholic fatty liver disease, Obesity, Metabolic syndrome, Bariatric surgeryAbstract
BACKGROUND: A possible direct link between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H. pylori) infection has recently emerged. OBJECTIVE: This study aimed to analyze associations between the presence of histologically demonstrated NAFLD aspects with H. pylori infection in individuals with obesity undergoing bariatric surgery. DESIGN AND SETTING: An observational analytical cross-sectional study was conducted based on data collected from the medical records of individuals undergoing bariatric surgery at a tertiary university hospital in 2019. METHODS: NAFLD was assessed through histological examination of wedge liver biopsies collected during the proceedings. H. pylori infection was analyzed through the association of the urease test and histological examination performed in biopsies routinely collected during preoperative esophagogastroduodenoscopy. RESULTS: Of the 88 participants, 85% were female, and the average age was 39.1 ± 8.4 years. H. pylori infection was present in 61.4% of the patients. The mean body mass index was 36.6 ± 3.4 kg/m2. The most prevalent histopathological aspects of NAFLD were macrovesicular steatosis (92%), hepatocellular ballooning (92%), lobular inflammation (93.2%), portal inflammation (96.6%), and fibrosis (93.2%). No histopathological aspect of NAFLD was found to be significantly associated with H. pylori infection. CONCLUSION: In this study population, H. pylori infection was not significantly associated with the histopathological aspects of NAFLD in individuals with obesity undergoing bariatric surgery.
Downloads
References
Tang DM, Kumar S. The Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease. Curr Gastroenterol Rep. 2017;19(2):5. PMID: 28155087; https://doi.org/10.1007/s11894-017-0545-1.
Valadares EC, Gestic MA, Utrini MP, et al. Pre-operative screening of Helicobacter pylori in bariatric patients: is histopathological analysis necessary? Arq Gastroenterol. 2022;59(2):275-80. PMID: 35830041; https://doi.org/10.1590/S0004-2803.202202000-49
Mantovani A, Turino T, Altomari A, et al. Association between Helicobacter pylori infection and risk of nonalcoholic fatty liver disease: An updated meta-analysis. Metabolism. 2019;96:56-65. PMID: 31047909; https://doi.org/10.1016/j.metabol.2019.04.012.
Wei L, Ding HG. Relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease: What should we expect from a meta-analysis? Medicine (Baltimore). 2021;100(31):e26706. PMID: 34397807; https://doi.org/10.1097/MD.0000000000026706.
Brunt EM, Kleiner DE, Wilson LA, et al. Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings. Hepatology. 2011;53(3):810-20. PMID: 21319198; https://doi.org/10.1002/hep.24127.
Fuchs HF, Broderick RC, Harnsberger CR, et al. Benefits of bariatric surgery do not reach obese men. J Laparoendosc Adv Surg Tech A. 2015;25(3):196-201. PMID: 25654317; https://doi.org/10.1089/lap.2014.0639.
Polyzos SA, Kountouras J, Zavos C, Deretzi G. The association between Helicobacter pylori infection and insulin resistance: a systematic review. Helicobacter. 2011;16(2):79-88. PMID: 21435084; https://doi.org/10.1111/j.15235378.2011.00822.x.
Chen LW, Chien CY, Yang KJ, et al. Helicobacter pylori Infection Increases Insulin Resistance and Metabolic Syndrome in Residents Younger than 50 Years Old: A Community-Based Study. PLoS One. 2015;10(5):e0128671. PMID: 26020514; https://doi.org/10.1371/journal.pone.0128671.
Zhou X, Liu W, Gu M, Zhou H, Zhang G. Helicobacter pylori infection causes hepatic insulin resistance by the c-Jun/miR-203/SOCS3 signaling pathway. J Gastroenterol. 2015;50(10):1027-40. PMID: 25689935; https://doi.org/10.1007/s00535-015-1051-6.
Gunji T, Matsuhashi N, Sato H, et al. Helicobacter pylori infection significantly increases insulin resistance in the asymptomatic Japanese population. Helicobacter. 2009;14(5):144-50. PMID: 19751440; https://doi.org/10.1111/j.15235378.2009.00705.x.
Di Leo V, D’Inca R, Bettini MB, et al. Effect of Helicobacter pylori and eradication therapy on gastrointestinal permeability. Implications for patients with seronegative spondyloarthritis. J Rheumatol. 2005;32(2):295-300. PMID: 15693091.
Fukuda Y, Bamba H, Okui M, et al. Helicobacter pylori infection increases mucosal permeability of the stomach and intestine. Digestion. 2001;63 Suppl 1:93-6. PMID: 11173917; https://doi.org/10.1159/000051918.
Fedwick JP, Lapointe TK, Meddings JB, Sherman PM, Buret AG. Helicobacter pylori activates myosin light-chain kinase to disrupt claudin-4 and claudin-5 and increase epithelial permeability. Infect Immun. 2005;73(12):7844-52. PMID: 16299274; https://doi.org/10.1128/IAI.73.12.7844-7852.2005.
Cazzo E, Jimenez LS, Gallo Fde F, Pareja JC, Chaim EA. Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study. Sao Paulo Med J. 2016;134(1):79-83. PMID: 26786607; https://doi.org/10.1590/1516-3180.2015.01652409.
Tanase DM, GosavEM, Costea CF, et al. The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Nonalcoholic Fatty Liver Disease (NAFLD). J Diabetes Res. 2020;2020:3920196. PMID: 32832560; https://doi.org/10.1155/2020/3920196.
Cazzo E, Jimenez LS, Gestic MA, et al. Type 2 Diabetes Mellitus and Simple Glucose Metabolism Parameters may Reliably Predict Nonalcoholic Fatty Liver Disease Features. Obes Surg. 2018;28(1):187-94. PMID: 28741239; https://doi.org/10.1007/s11695-017-2829-9.
Jiang T, Chen X, Xia C, et al. Association between Helicobacter pylori infection and non-alcoholic fatty liver disease in North Chinese: a cross-sectional study. Sci Rep. 2019;9(1):4874. PMID: 30890750; https://doi.org/10.1038/s41598-019-41371-2.
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):1201-10. PMID: 28382402; https://doi.org/10.1007/s00535-017-1337-y.
Okushin K, Takahashi Y, Yamamichi N, et al. Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan. BMC Gastroenterol. 2015;15:25. PMID: 25880912; https://doi.org/10.1186/s12876-015-0247-9.
Fan N, Peng L, Xia Z, et al. Helicobacter pylori Infection Is Not Associated with Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study in China. Front Microbiol. 2018;9:73. PMID: 29445363; https://doi.org/10.3389/fmicb.2018.00073.
Baeg MK, Yoon SK, Ko SH, et al. Helicobacter pylori infection is not associated with nonalcoholic fatty liver disease. World J Gastroenterol. 2016;22(8):2592-600. PMID: 26937147; https://doi.org/10.3748/wjg.v22. i8.2592.
Jamali R, Mofid A, Vahedi H, Farzaneh R, Dowlatshahi S. The effect of helicobacter pylori eradication on liver fat content in subjects with non-alcoholic Fatty liver disease: a randomized open-label clinical trial. Hepat Mon. 2013;13(12):e14679. PMID: 24358044; https://doi.org/10.5812/hepatmon.14679.
Lecube A, Valladares S, López-Cano C, et al. The Role of Morbid Obesity in the Promotion of Metabolic Disruptions and Non-Alcoholic Steatohepatitis by Helicobacter Pylori. PLoSOne. 2016;11(11):e0166741. PMID: 27893763; https://doi.org/10.1371/journal.pone.0166741.
Doulberis M, Srivastava S, Polyzos SA, et al. Active Helicobacter pylori Infection is Independently Associated with Nonalcoholic Steatohepatitis in Morbidly Obese Patients. J Clin Med. 2020;9(4):933. PMID: 32235601; https://doi.org/10.3390/jcm9040933.
