Associations of Helicobacter pylori infection with NAFLD, MAFLD, MASLD, and Chinese MAFLD
In brief
Helicobacter pylori infection quadruples odds of severe fatty liver
In a cross-sectional study of over 1,100 inpatients, H. pylori-positive individuals had about four times higher odds of severe hepatic steatosis across NAFLD, MAFLD and MASLD definitions, after adjusting for metabolic risk factors. The infection was not linked to liver fibrosis, and the association did not appear for the Chinese-specific MAFLD criteria, leaving its clinical relevance uncertain.
- Journal
- Therapeutic advances in gastroenterology (Q1)
- Published
- 31 July 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Honglu Yu, Yuting Gao, Xiaomin Wang, Lan Chen, Yongguo Zhang, Hongyu Li, et al.
- PMID
- 42542759
- DOI
- 10.1177/17562848261465720
Why clinicians should know about it
- Picked for Gastroenterology (paper of the day, 3 August 2026): Helicobacter pylori infection associations with NAFLD/MAFLD
- Picked for Hepatology (paper of the day, 3 August 2026).
Abstract
BACKGROUND: The association of Helicobacter pylori (H. pylori) infection with non-alcoholic fatty liver disease (NAFLD) remains controversial. Additionally, its associations with metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), and Chinese MAFLD using the most recent diagnostic criteria were unclear. OBJECTIVE: To analyze the associations of H. pylori infection with NAFLD, MAFLD, MASLD, and Chinese MAFLD. DESIGN: Cross-sectional study. METHODS: This study screened 1172 inpatients who underwent both H. pylori test and liver computed tomography or ultrasound examination between June 2020 and May 2024. Multivariate Logistic regression analyses were performed to evaluate the associations of H. pylori infection with the severity of hepatic steatosis and risk of hepatic fibrosis. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated after adjusting for gender, hypertension, hyperlipidemia, body mass index (BMI), fasting plasma glucose (FPG), and high-sensitivity C-reactive protein (HsCRP) in NAFLD analyses; age, gender, drinking, hypertension, diabetes, hyperlipidemia, BMI, and HsCRP in MAFLD analyses; and gender, drinking, hypertension, hyperlipidemia, BMI, FPG, and HsCRP in MASLD and Chinese MAFLD analyses. RESULTS: Overall, 875, 982, 869, and 869 patients were included in NAFLD, MAFLD, MASLD, and Chinese MAFLD analyses, respectively. In NAFLD, MAFLD, MASLD, and Chinese MAFLD analyses, 257, 302, 257, and 257 patients had H. pylori infection, respectively. H. pylori infection was independently associated with severe hepatic steatosis in NAFLD (aOR = 3.956; 95% CI = 1.171-13.359, p = 0.027), MAFLD (aOR = 3.730; 95% CI = 1.083-12.850, p = 0.037), and MASLD (aOR = 3.962; 95% CI = 1.158-13.557, p = 0.028) analyses, but not Chinese MAFLD analyses. However, H. pylori infection was not independently associated with the risk of hepatic fibrosis. CONCLUSION: H. pylori infection may increase the severity of NAFLD, MAFLD, and MASLD, but not the risk of liver fibrosis.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.