Helicobacter pylori infection is linked to metabolic dysfunction and associated steatotic liver disease: A large cross-sectional study

Table 1 Comparison of clinical data between Helicobacter pylori-positive and Helicobacter pylori-negative groups

Parameter	H. pylori-negative group (n = 20946)	H. pylori-positive group (n = 7678)	t value	P value
Age (years)	46 ± 14.86	46.43 ± 14.45	2.443	0.015
Blood glucose (mmol/L)	5.27 ± 1.23	5.43 ± 1.55	-7.79	0.001
HDL (mmol/L)	1.41 ± 0.37	1.38 ± 0.37	4.23	0.001
Total cholesterol (mmol/L)	4.85 ± 0.97	4.88 ± 0.99	-2.37	0.018
Triglycerides (mmol/L)	1.62 ± 1.48	1.65 ± 1.48	-1.61	0.107
LDL (mmol/L)	2.94 ± 0.75	2.97 ± 0.76	-3.2	0.001
BMI (kg/m²)	23.64 ± 3.35	23.89 ± 3.46	-5.3	0.001
Systolic blood pressure (mmHg)	122.85 ± 18.33	123.49 ± 19.06	-2.57	0.009
Diastolic blood pressure (mmHg)	74.9 ± 11.9	75.48 ± 12.37	-3.53	0.001
Gender (male/female)	11803/9143	4258/3420	χ2 = 1.821	0.179
MASLD detection rate	7424/13522	2845/4833	χ2 = 6.331	0.012

¹The test method for this item is the χ² test.

Data are presented as mean ± SD or n (%). Continuous variables were analyzed via the Student’s t-test; categorical variables were analyzed via the χ² test. H. pylori: Helicobacter pylori; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; BMI: Body mass index; MASLD: Metabolic dysfunction-associated steatotic liver disease.

Table 2 Comparison of clinical data between Helicobacter pylori-positive and Helicobacter pylori-negative groups within the metabolic dysfunction-associated steatotic liver disease cohort

Parameter	H. pylori-negative group (n = 7424)	H. pylori-positive group (n = 2845)	t value	P value
Age (year)	48.39 ± 13.77	48.91 ± 13.19	-1.76	0.79
Blood glucose	5.60 ± 1.60	5.82 ± 1.95	-5.3	0.001
HDL (mmol/L)	1.23 ± 0.30	1.22 ± 0.30	1.31	0.191
Total cholesterol (mmol/L)	5.00 ± 1.00	5.05 ± 1.03	-2.07	0.039
Triglycerides (mmol/L)	2.27 ± 1.99	2.30 ± 1.91	-0.404	0.686
LDL (mmol/L)	3.13 ± 0.75	3.16 ± 0.76	-1.78	0.076
BMI (kg/m²)	26.04 ± 2.96	26.23 ± 3.00	-2.88	0.004
Systolic blood pressure (mmHg)	128.49 ± 17.62	129.5 ± 20.00	-2.6	0.009
Diastolic blood pressure (mmHg)	79.04 ± 11.76	79.87 ± 12.07	-3.16	0.002
Gender (male/female)	5538/1886	2075/770	χ2 = 2.9591	0.85

¹The test method for this item is the χ² test.

Data are presented as the mean ± SD or n (%). Continuous variables were analyzed via the Student’s t-test; categorical variables were analyzed via the χ² test. H. pylori: Helicobacter pylori; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; BMI: Body mass index.

Table 3 Age-stratified prevalence of Helicobacter pylori infection and statistical comparisons

Age group	Number of cases	H. pylori-positive cases	H. pylori-positivity rate (%)	χ2	P value
18-29	4501	1106	24.6	34.661	0.001
30-49	12047	3241	26.9
50-69	12078	2862	23.7
≥ 70	1798	469	26.1

The χ² trend test was used to evaluate age-related trends in infection rates. H. pylori: Helicobacter pylori.

Table 4 Age-stratified prevalence of metabolic dysfunction-associated steatotic liver disease

Age group	Number of cases	MASLD cases	MASLD detection rate (%)	χ2	P value
18-29	4501	911	20.2	431.65	0.001
30-49	12047	4345	36.1
50-69	12078	4354	36.0
≥ 70	1798	659	36.7

The χ² trend test was used to assess age-related trends. MASLD: Metabolic dysfunction-associated steatotic liver disease.

Table 5 Body mass index-stratified prevalence of Helicobacter pylori infection and statistical comparisons

BMI	Number of cases	H. pylori positive cases	H. pylori positivity rate (%)	χ2	P value
< 18	805	237	29.4%	44.654	0.001
18 ≤ BMI < 24	15150	3826	25.3%
24 ≤ BMI < 28	9759	2743	28.1%
≥ 28	2910	872	30.0%

The χ² trend test was used to evaluate body mass index-related trends. BMI: Body mass index; H. pylori: Helicobacter pylori.

Table 6 Multivariable logistic regression analysis of risk factors for Helicobacter pylori infection

Variable	β	β SE	Wald	P value	OR	95%CI
Age	0.001	0.001	0.254	0.614	1.001	0.998-1.003
Blood glucose	0.76	0.01	57.568	0.001	1.079	1.058-1.100
HDL	-0.178	0.055	10.403	0.001	0.837	0.751-0.932
Total cholesterol	0.075	0.042	3.195	0.074	1.077	0.993-1.169
LDL	-0.041	0.049	0.694	0.405	0.96	0.871-1.057
BMI	0.016	0.005	9.816	0.002	1.016	1.006-1.026
Systolic blood pressure	-0.002	0.001	2.748	0.097	0.998	0.996-1.000
Diastolic blood pressure	0.003	0.002	3.991	0.048	1.003	1.000-1.007
MASLD	-0.058	0.034	2.858	0.091	0.944	0.883-1.009

Notably, higher blood glucose [odds ratio (OR) = 1.079], body mass index (OR = 1.016), and diastolic blood pressure (OR = 1.003) levels were independent risk factors for Helicobacter pylori infection, whereas elevated high-density lipoprotein (OR = 0.837) levels had a protective effect. Metabolic dysfunction-associated steatotic liver disease was not significantly associated with infection risk (P = 0.091). OR: Odds ratio; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; BMI: Body mass index; MASLD: Metabolic dysfunction-associated steatotic liver disease.