Aim: Nonalcoholic fatty liver disease (NAFLD) is characterized by the presence of hepatic steatosis without any secondary causes contributing to the accumulation of fat in the liver. The influence of gut microbiota, including Helicobacter pylori (H. pylori), on liver injury has not been thoroughly investigated.
Methods: This cross-sectional case-control study involved sixty patients with NAFLD (group 1) and sixty healthy individuals of matched age and sex as the control group (group 2). NAFLD patients were diagnosed by ultrasound, aged≥ 18 years old, and body mass index (BMI) ≥ 30 kg/m². Investigations included fasting insulin level, fasting blood glucose (FBG), cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), liver profile, H. pylori antigen in stools, H. pylori IgG antibodies (IgG Abs) and homeostatic model assessment for insulin resistance (HOMA-IR).
Results: Group 1 had significantly higher systolic and diastolic blood pressures (p < 0.001 and 0.015, respectively). Additionally, the NAFLD group exhibited significantly elevated levels of FBG (p = 0.004), HbA_1c (p < 0.001), cholesterol (p = 0.007), LDL-C (p = 0.001), alanine transferase (ALT) (p < 0.001), and aspartate transferase (AST) (p: 0.025). Furthermore, the NAFLD group had a significantly higher number of patients with positive H. pylori antibodies (p < 0.001), although the antibody titers were not statistically different between the two groups (p:  0.516).
Conclusion: Obese patients with NAFLD had a significantly higher number of patients with positive H. pylori antibodies and showed increased insulin resistance and dyslipidemia compared to the control group.