NAFLD is not independently associated with H. pylori in an Austrian screening collective

Introduction The association between Helicobacter pylori (H. pylori) infection and non-alcoholic fatty liver disease (NAFLD) is under debate. The available data are mainly from Asian patients, while information on Caucasians is scarce. We therefore investigated a large Austrian screening cohort to determine whether an association between NAFLD (evaluated by transient elastography) and H. pylori (assessed histologically) can be found.

Methods In total, 1445 participants undergoing colorectal cancer screening including gastroscopy, abdominal ultrasound, transient elastography using Fibroscan® and laboratory evaluations at a single-centre in Austria between 2016 and 2020 were evaluated. The primary endpoint was the diagnosis of NAFLD defined as controlled attenuation parameter (CAP) ≥ 248 db/m. H. pylori infection was assessed histologically from mucosal biopsies obtained via gastroscopy. Association between H. pylori and the presence/severity of NAFLD were evaluated using uni- and multivariable logistic regression. We calculated (adjusted) odds ratios (aOR) and respective 95 % confidence intervals (CIs).

Results 1211 patients had no evidence of H. pylori infection while 234 patients were tested positive. Age and sex were evenly distributed between groups (57 ± 12 years vs. 57 ± 13 years, p = 0.782; 48 % vs. 44 % female patients; p = 0.224). BMI was significantly higher in the H. pylori positive group (26 ± 5 vs. 27 ± 5 kg/m²; p = 0.003). Although NAFLD was more common in H. pylori-positive patients (56 % vs. 64 %; p = 0.020) in the univariable analysis, we could not show an independent association when adjusting for age, sex and BMI (body mass index) (aOR 1.198 [95 % CI, 0.828 - 1.733]) in multivariable regression analysis.

Conclusion H. pylori is not independently associated with NAFLD in a large, well-characterised central European CRC screening cohort.

Publikationsverlauf

Artikel online veröffentlicht:
01. September 2021