Helicobacter pylori infection is not associated with nonalcoholic fatty liver disease

Table 4 Characteristics of Studies Investigating Helicobacter pylori and nonalcoholic fatty liver disease

Ref.	Type of study	Country	No. of subjects (male)	H. pylori detection	H. pylori % (female/male)	NAFLD diagnosis	NAFLD % (female/male)	Association with H. pylori
Jamali et al[19], 2013	RCT1	Iran	100 (49)	13C UBT	100% (N/A)	Ultrasonography and elevated liver enzyme levels	100%	No association with H. pylori eradication
Polyzos et al[20], 2013	Cross-sectional	Greece	533	Serum IgG, history of H. pylori eradication	75.5% (N/A)	Liver biopsy	52.8% (39.6/13.2)	Higher IgG seropositivity in NAFLD group
Okushin et al[21], 2015	Cross-sectional	Japan	5289 (1816)	Serum IgG	27.4% (27.5/27.1)	Ultrasonography	34.1% (25.4/50.7)	None
Sumida et al[22], 2015	Cross-sectional	Japan	130 (65)	Serum IgG	40% (44.6/35.4)	Liver biopsy	100%	Associated with hepatocyte ballooning
Polyzos et al[36], 2014	Prospective2	Greece	12 (3)	13C UBT	50% (N/A)	NAFLD-LFS HSENSI MRI-HFF	100%	Significant in HSENSI only

¹Data compared between H. pylori eradication and lifestyle modification group vs lifestyle modification only group;

²Data collected at baseline and 12 months after H. pylori eradication;

³28 (7 males) NAFLD cases vs 25 (5 males) controls. NAFLD: Nonalcoholic fatty liver disease; RCT: Randomized controlled trial; UBT: Urea breath test; N/A: Not available; IgG: Immunoglobulin G; NAFLD-FS: Nonalcoholic fatty liver disease liver fat score; HSENSI: Homocysteine, serum glutamic oxaloacetic transaminase, erythrocyte sedimentation rate, nonalcoholic steatohepatitis index; MRI-HFF: Magnetic resonance imaging hepatic fat fraction.