Non-alcoholic fatty liver disease and Helicobacter pylori infection: is there a relationship? Review

Abstract

The article outlines the relevance of finding a connection between non‑alcoholic fatty liver disease (NAFLD) and Helicobacter pylori infection. The presented data of the majority of studies indicate the presence of Helicobacter pylori infection as a risk factor for the development of NAFLD. In addition, a number of researchers point to the possibility of the influence of Helicobacter pylori on important pathogenetic chains of NAFLD: insulin resistance, the state of the intestinal microbiota, the level of such hormones as ghrelin, leptin, adiponectin, and also that the effect of Helicobacter pylori (H. pylori) toxins can cause direct damage to the liver and that Helicobacter pylori invasion of the small intestine mucosa can increase the permeability of the latter, disrupting the functioning of the gut—liver axis. The article emphasizes the relationship between H. pylori infection and an unfavorable metabolic profile: dyslipidemia, body mass index, blood pressure, fasting blood glucose, and insulin resistance. In addition, research data on the novelty of higher levels of aspartate and alanine aminotransferase in Helicobacter‑positive patients compared to Helicobacter‑negative patients, in the absence of differences in liver fibrosis, are given. Separately, the research data are given, which indicate that the successful eradication of Helicobacter infection does not have a significant effect on liver steatosis, but probably reduces the severity of insulin resistance. Also, the authors draw attention to the fact that in a number of studies, the connection of H. pylori with NAFLD was not found, and no significant differences were found in the levels of high and low‑density lipoprotein cholesterol in people with Helicobacter infection compared to Helicobacter‑negative ones. The authors conclude that today there is no clear understanding of the role of Helicobacter pylori infection in the NAFLD pathogenesis, which requires further research because, after all, most researchers testify in favor of the fact that H. pylori infection can be one of the risk factors, contributing to the emergence and progression of NAFLD, and eradication of H. pylori may be important in the treatment of this disease.