Review
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World J Gastroenterol. Nov 7, 2013; 19(41): 7024-7031
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7024
Potential role of Helicobacter pylori infection in nonalcoholic fatty liver disease
Meng Li, Zhe Shen, You-Ming Li
Meng Li, Zhe Shen, You-Ming Li, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Li M designed research, performed literature search and wrote the paper; Shen Z and Li YM analyzed data and critically revised the paper.
Supported by The National Natural Science Foundation of China, No. 81230012; Zhejiang Provincial Laboratory Animal Science Technology Program of China, No. 2011C37088; the National Natural Science Foundation of China, No. 81300303
Correspondence to: You-Ming Li, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zliyouming@126.com
Telephone: +86-571-87236532 Fax: +86-571-87236532
Received: July 30, 2013
Revised: September 5, 2013
Accepted: September 15, 2013
Published online: November 7, 2013
Abstract

Accumulating evidence has implicated Helicobacter pylori (H. pylori) infection in extragastrointestinal diseases, including obesity, type 2 diabetes mellitus, cardiovascular disease, and liver disease. Recently, there has been a special focus on H. pylori infection as a risk factor for the development of nonalcoholic fatty liver disease (NAFLD). NAFLD is currently considered to be the most common liver disorder in western countries, and is rapidly becoming a serious threat to public health. The mechanisms of pathogenesis underlying NAFLD remain unclear at present and therapeutic options are limited. The growing awareness of the role of H. pylori in NAFLD is thus important to aid the development of novel intervention and prevention strategies, because the eradication of H. pylori is easy and much less expensive than long-term treatment of the other risk factors. H. pylori infection is involved in the pathogenesis of insulin resistance (IR), which is closely linked with NAFLD. It provides a new insight into the pathogenesis of NAFLD. This review probes the possible relationship between H. pylori and NAFLD, from the perspective of the potential mechanism of how H. pylori infection brings about IR and other aspects concerning this correlation.

Keywords: Helicobacter pylori, Nonalcoholic fatty liver disease, Insulin resistance, Inflammation, Cytokines

Core tip: A growing body of evidence suggests that Helicobacter pylori (H. pylori) infection is linked with nonalcoholic fatty liver disease (NAFLD). There are some potential pathogenic mediators and mechanisms involved in this progress, including fetuin-A, tumor necrosis factor-α and adiponectin. Long-term H. pylori infection may cause insulin resistance and inflammation, contributing to NAFLD. H. pylori toxins in the portal circulation arising from the gastroduodenal area may be another intriguing point, which might be related to the increased intestinal permeability in patients with NAFLD. It is hoped that eradication of H. pylori will provide a new treatment strategy for NAFLD.