Impact of Helicobacter pylori Eradication on the Risk of Incident Nonalcoholic Fatty Liver Disease: A Cohort Study

Abstract

Background/Aims: Previous studies have reported an association between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and nonalcoholic fatty liver disease (NAFLD). Our study examined whether eradication for <i>H. pylori</i> infection reduces the risk of incident NAFLD.Materials and Methods: This retrospective cohort study examined 3,780 adults who had no NAFLD at baseline but were infected with <i>H. pylori</i>. The study population was followed from January 1995 until January 2020. <i>H. pylori</i> infection was determined by an <i>H. pylori</i>-specific IgG antibody test. Fatty liver was diagnosed by ultrasound.Results: During a median follow-up of 7.9 years, 1,294 participants developed NAFLD. In a multivariable model adjusted for age, sex, BMI, smoking status, alcohol intake, and metabolic variables, the uneradicated (for <i>H. pylori</i>) group exhibited a higher risk of incident NAFLD than the eradicated group (hazard ratio [HR], 1.36; 95% CI, 1.18~1.56). The multivariable analysis also demonstrated that higher BMI, current smoking and several metabolic abnormalities were significant risk factors for NAFLD. Subgroup analyses revealed that persistent <i>H. pylori</i> infection correlated with an increased risk of NAFLD. <i>H. pylori</i> eradication was associated with a decreased risk of NAFLD development.Conclusions: <i>H. pylori</i> infection may have a pathophysiological role in NAFLD development. Hence, successful eradication of <i>H. pylori</i> decreases the risk of incident NAFLD.