Meta-analysis Of Relationship Between Helicobacter Pylori And Non-alcoholic Fatty Liver Disease

Objective:Non-alcoholic fatty liver disease(NAFLD),currently renamed as metabolic related liver disease(MAFLD),is a liver manifestation of metabolic syndrome.NAFLD has become one of the most common liver diseases in the world,with repeated onset of chronic diseases,and in severe cases,liver fibrosis,cirrhosis and liver cancer,which are harmful to human health.However,the pathogenesis of this disease is still unclear,and most people believe that it is the result of multiple factors such as genetic susceptibility,insulin resistance,dyslipidemia,and intestinal flora imbalance,etc.The therapeutic effect still cannot reach the ideal state.Therefore,finding new therapeutic targets has become a hot topic.Common pathogenic bacteria helicobacter pylori is the stomach is chronic gastritis,gastric and duodenal ulcer,gastric lymphoma,the main causes of stomach cancer,a study that h.pylori infection and insulin resistance,lipid metabolic disorder,associated intestinal dysbacteriosis,lead to helicobacter pylori infection in patients with increased risk for NAFLD,therefore,at home and abroad to study the helicobacter pylori infection and the relationship between nonalcoholic fatty liver disease.The relationship between HELICobacter pylori infection and nonalcoholic fatty liver disease(NAFLD)remains controversial in published studies.Therefore,we conducted a meta-analysis to better identify the relationship between helicobacter pylori infection and nonalcoholic fatty liver disease(NAFLD),and provide new ideas for the treatment of nonalcoholic fatty liver disease(NAFLD).Methods:Through a comprehensive search of articles on the correlation between Helicobacter pylori and non-alcoholic fatty liver on Web of Science,Pubmed,EMBASE,Cn KI,VIP database and Wanfang database,the retrieval time was set up until November 1,2020.Case control studies and cohort studies used Newcastle-Ottawa Quality Assessment Scale(NOS)for quality assessment,while cross-sectional studies used JBI scale for quality assessment.Stata version 15 was used for statistical analysis of all the data.Odds ratio(OR),standard mean difference(SMD)and 95%confidence interval(CIs)were calculated by random effects model.Subgroup analysis and sensitivity analysis were conducted,and publication bias was assessed by funnel plots and Egger tests.Results:1,a total included in article 15,a total of 80727 participants,from the national respectively(10,1 piece of Japan and China 2 papers to Egypt,1 piece of South Korea,Switzerland),included in the study of type(10 cross-sectional study,3case-control studies and cohort study 2),including 8 English article,seven Chinese article,publication date for the 2013 to 2020.In this study,meta analysis was conducted to determine whether Hp infection is a risk factor for NAFLD and the correlation between Hp infection and blood lipid,blood glucose and BMI.2,the Hp positive patients with NAFLD,meta analysis results show that compared with Hp negative groups,Hp positive group of NAFLD cancer rate higher(OR = 1.54,95% CI 1.33 1.78,P < 0.05),as a result of the research significant heterogeneity(I2 = 92%,P < 0.1),we performed subgroup analysis to explore the sources of heterogeneity,including sample size < 1000(I2 = 56.8%),case-control study group(0.0%)and the heterogeneity decreased significantly,prompt sample size,research type may be a source of heterogeneity,In addition,it was found that the combined effect amounts of the two subgroups in the low-quality literature and the cohort study were not statistically significant(P ≥0.05),while those of the other subgroups were statistically significant(P < 0.01),generally indicating that Hp infection is a risk factor for NAFLD.Meta analysis of Hp infection,blood lipids,blood glucose and BMI suggested that Hp infection had an impact on triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL-C)and high-density lipoprotein(HDL-C)to a certain extent.The sensitivity analysis shows that the results are stable and reliable.The funnel plot and egger test results showed that there was no publication bias in the study(P>0.05).Conclusion:Helicobacter pylori infection may be a risk factor for the development of nonalcoholic fatty liver disease,and may indirectly promote the development of nonalcoholic fatty liver disease by influencing the metabolism of blood lipids,which still needs to be further confirmed by large sample studies.