Review Article

Relationship of Helicobacter pylori Infection with Nonalcoholic Fatty Liver Disease: A Meta-Analysis

Table 1

Characteristics of studies regarding the association of H. pylori infection with NAFLD.

First author (year)CountryStudy designPublication formDiagnostic methods of H. pyloriDiagnostic methods of NAFLDNAFLDControlAdjusted OR/HR (95% CI)Adjusted confounders
HP+HPHP+HP

Wernly (2022)AustriaCross-sectionalFull textRUTUS487194053223790.96 (0.82, 1.13)Age, gender, type 2 diabetes, and LDL
Wang (2022)ChinaCross-sectionalFull text13C-UBTUS86171467816128322101.02 (0.97, 1.08)Age, gender, BMI, SBP, DBP, FBG, HbA1C, LDL-C, HDL-C, TG, AST, ALT, GGT, Scr, and BUN
Zhao (2022)ChinaCohortFull text13C-UBTUS3773169396NANA
Kim (2022)South KoreaCohortFull textSerologyUSNANANANA1.36 (1.18, 1.56)SBP, FPG, TG, LDL-C, HDL-C, ALT, GGT, and HS-CRP
Choi (2022)South KoreaCross-sectionalFull textSerologyUS6604457045481.36 (1.04, 1.78)BMI, HTN, diabetes, dyslipidemia, and smoking
Han (2021)South KoreaCross-sectionalFull textSerologyUS3435283655480.96 (0.78, 1.19)Age, gender, HTN, diabetes, BMI, fasting glucose, TG, HDL-C, and LSM
Ying (2021)ChinaCross-sectionalFull text13C-UBTUS141225436851025NANA
Ping (2021)ChinaCross-sectionalFull text13C-UBTUS2302992344221.38 (1.09, 1.75)Age, carotid plaque status, ALT, AST, UA, FPG, TC, TG, SBP, DBP, LDL-C, and BMI
Wang (2021)ChinaCross-sectionalFull text13C-UBTUS199306490903NANA
Rahman (2020)BangladeshCross-sectionalFull textSerologyUS62793562701.50 (0.94, 2.39)Age, gender, religion, BMI, DM, marital status, smoking, occupation, monthly income, MS, and education
Amer (2020)EgyptCross-sectionalFull textSATUS442829626NANA
Alvarez (2020)GuatemalaCross-sectionalFull textSerologyFLI > 60 and HSI > 362222914528NANA
Doulberis (2020)SwitzerlandCase-controlFull textRUTLiver biopsy154009NANA
Xu (2020)ChinaCross-sectionalFull textSerologyUS25162309528778591.66 (1.55, 1.79)Age, gender, underlying diseases, and MS
Tian (2019)ChinaCross-sectionalFull text13C-UBTUS1022842111511021.27 (1.07, 1.50)Age, gender, education level, smoking, HTN, diabetes, dyslipidemia, BMI, ALT, AST, AKP, TBIL, UA, and urea
Yu (2019)ChinaCross-sectionalFull textRUTUS583851379589NANA
Mahyar (2019)IranCross-sectionalFull textSerology and SATUS22431550NANA
Abdel-Razik (2018)EgyptCohortFull textSATUS, HSI > 36 and NAFLD-LFS > −0.6402301481981.08 (1.02, 1.25)Age, gender, BMI, smoking, crowding index, education level, regular exercise, CRP, IL-6, TNF-α, HOMA-IR, FPG, TC, HDL-C, LDL-C, TG, and UA
Yu (2018)ChinaCross-sectionalFull text14C-UBTUS3132446047168081NANA
Fan (2018)ChinaCross-sectionalFull text14C-UBTUS390557686943115541.00 (0.70, 1.30)Age, gender, BMI, SBP, DBP, FPG, HbA1c, TG, TC, LDL-C, HDL-C, UA, and Scr
Lu (2018)ChinaCross-sectionalFull text13C-UBTUS199397390881NANA
Kang (2018)USACross-sectionalFull textSerologyUS6581065111525661.17 (0.95, 1.43)Age, gender, race ethnicity, income, diabetes, HTN, smoking, waist circumference, alcohol and caffeine consumption, TC, HDL-C, and transferrin saturation
Cai (2018)ChinaCross-sectionalFull text13C-UBTUS14528850011180.94 (0.70, 1.27)Gender, BMI, TG, HDL-C, and FPG
Kim (2017)South KoreaCohortFull textSerologyUS20801301783858091.16 (1.05, 1.30)Age, gender, BMI, year of screening exam, smoking status, alcohol intake, regular exercise, and education level, HS-CRP, HOMA-IR, SBP, FPG, TG, LDL-C, HDL-C, AST, ALT, and GGT
Chen (2017)ChinaCross-sectionalFull text13C-UBTUS3132907239371.39 (1.05, 1.73)Age, gender, UA, AST, ALT, GGT, TG, BMI, waist circumference, and HbA1C
Kumar (2017)IndiaCross-sectionalAbstractRUTUS11162073NANA
Albert (2016)SpainCross-sectionalFull textRUTLiver biopsy2641102517NANA
Baeg (2016)South KoreaCross-sectionalFull text13C-UBTHSI > 36505440113115871.13 (0.97, 1.31)Age, gender, smoking, and HS-CRP
Tang (2016)USACross-sectionalAbstractRUT, serology or SATUS or liver biopsy4973401081.18 (1.00, 2.96)Age, gender, and statin use
Zhang (2016)ChinaCase-controlFull text14C-UBTLiver biopsy3003001444563.17 (1.91, 5.74)Gender and geriatric diseases
Okushin (2015)JapanCross-sectionalFull textSerologyUS52312799262561NANA
Sumida (2015)JapanCross-sectionalFull textSerologyLiver biopsyNANANANA2.92 (1.11, 7.64)Age, gender, BMI, dyslipidemia, HTN, and diabetes
Polyzos (2013)GreeceCase-controlFull textSerologyLiver biopsy2351411NANA
Shen (2013)ChinaCross-sectionalAbstractSerologyUS566130718045414NANA

AKP: alkaline phosphatase, ALT: alanine aminotransferase, AST: aspartate aminotransferase, BMI: basal metabolic index, BP: blood pressure, BUN: blood urea nitrogen, CRP: C-reactive protein, CI: confidence intervals, DBP: diastolic blood pressure, DM: diabetes mellitus, FBG/FPG: fasting plasma glucose, FLI: fatty liver index, GGT: gamma-glutamyl transpeptidase, HbA1c: glycosylated hemoglobin, HDL-C: high-densitylipoprotein-cholesterol, HP: Helicobacter pylori, HS-CRP: high-sensitivityC-reactive protein, HOMA-IR: homeostatic model assessment-insulin resistance, HR: hazard ratio, HSI: hepatic steatosis index, HTN: hypertension, IL-6: interleukin-6, LDL: low-density lipoprotein, LDL-C: low-densitylipoprotein-cholesterol, LSM: liver stiffness measurements, MS: metabolic syndrome, NA: not available, NAFLD: nonalcoholic fatty liver disease, NAFLD-LFS: NAFLD-liver fat score, OR: odds ratio, PG: pepsinogen, RUT: rapid urease test, SAT: stool antigen test, Scr: serum creatinine, SBP: systolic blood pressure, TBIL: total bilirubin, TC: total cholesterol, TG: triglycerides, TNF-α: tumor necrosis factor-alpha, UA: uric acid, UBT: urea breath test, US: ultrasonography, and USA: the United States of America.