Effect Of Helicobacter Pylori Eradication On Nonalcoholic Fatty Liver Disease

Objective:1.To evaluate the effect of eradication of Helicobacter pylori(Hp)on liver fat content(LFC)in patients with nonalcoholic fatty liver disease(NAFLD)was evaluated by noninvasive method of semi-quantitative scoring and the equation for prediction of liver fat content.2.The aim of this study was to evaluate the effects of eradication Helicobacter pylori(Hp)on liver function test,blood lipid index,fasting blood glucose,fasting insulin,homeostatic model assessment-IR(HOMA-IR),clinical symptoms and human body in patients with nonalcoholic fatty liver disease(NAFLD)to provide theoretical basis for the treatment of NAFLD,and to provide reference for clinical prevention.Methods:1.According to the inclusion and exclusion criteria random collection the Participants who attend to Yan’an University Affiliated Hospital in 2015.11-2017.2.Participants with ultrasound criteria for identification of fatty liver were presumed to have NAFLD.NAFLD and positive results for 14 carbon urea breath test(14C-UBT)were included.General information and clinical symptoms of patients was collecte to all participants.2.All participants received quadruple therapy with rabeprazole sodium enteric capsules(20mg qd),colloidal pectin bismuth particles(150mg qid),amoxicillin capsules(1000mg bid),and levofloxacin hydrochloride capsule(200mg bid)for two weeks.After a welve-hour overnight fast,sera of the participants were tested to investigate aspartate aminotransferase(AST),alanineaminotransferase(ALT),triglyceride(TG),totalcholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and fasting plasma glucose(FPG)by Beckman Dix 800 automatic biochemical analyzer.The fasting serum insulin(FINS)was measured based on a sandwich enzyme immunoassay using acommercially availablekit.The insulin resistance index(homeostatic model HOMA-IR)was used to evaluate the level of insulin resistance.The fat level of the liver was measured by the US G-7 Color B Ultrasound Machine.The fat content was performed using the calculation formula of liver fat content and the ultrasonic meter Quantitative calculation by semi-quantitative method.All of the above indicators were detected before eradication of Helicobacter pylori and after 6 months of successful eradication.3.SPSS20.0 statistical software was used to analyze the above results.The data of the normal distribution were expressed as mean ± standard deviation((?)± s).The comparison of the normal distribution data before and after the eradication treatment was compared with the paired t test.Non-normal distribution data were expressed as median± four quartile spacing(M ± Q).The comparison of the non-normal distribution data was used Wilcoxon Symbol Rank Sum Test for Pairing Data.Above statistical analysis was statistically significant with P <0.05.Result:1.This study incorporates the general data of the researchers1.1 The average age was 46.28 ± 11.14 years;the average height was 170.00 ±14.25cm;the highest age was 24 years old,the highest age was 69 years old,the average age was 46.28 ± 11.14 years;the average height was 170.00 ± 14.25cm;the average age was 170.00 ± 14.25cm;Average weight 74.00 ± 12.50Kg;average waist circumference95.76 ± 5.92cm;average body mass 25.89 ± 2.05 Kg / m2.1.2 The subjects had 39 cases of primary hypertension,accounting for 47.56% of the total,including male 16(41.03%),female 23 cases(58.97%);34 subjects with type 2diabetes,the total number of 41.46%,Male 17(50%),female 17(50%);type 2 diabetes with hypertension in 20 patients,including male 7(35%),female 13(65%).1.3 The severity classification of Liver fatty content by B ultrasound,of which 57 cases of mild fatty liver,the total number of 69.51%,of which 33(57.89%),(57.89%),female 24(42.11%),moderate fatty liver 22(14.63%),and moderate fatty liver(57.69%).(9.9%),female 13(59.09%),severe fatty liver 3(3.65%),male 2(66.67%),female 1(33.33%).2.Hp treatment of adverse reactions,compliance and eradication rateNo side effects were required during the study to reduce the dose or discontinuation.Followed medication time and taking found that patients with good compliance.All patients included in the study eradication rates of Hp were evaluated by protocol analysis(PP)analysis,and the eradication rate of Hp was 90.08% with 14C-UBT.3.Comparison of clinical symptoms before and after eradication of Hp: The difference between the symptom score and the pre-treatment symptoms was statistically significant after 6 months of eradication of Hp(Z =-7.906 a,P = 0.000).4.Comparison of Hp before and after the study of human body measurement indicators(weight,waist circumference,body mass)comparisonThere was no significant difference in f human body measurement indicators between investigators after Hp treatment(Z=-1.496,P=0.135)、(T=1.927,P=0.057)、(T=1.582,P=0.118).5.Comparison of serum markers before and after Hp eradicationThere was no significant difference in serum AST,ALT,TG and TC levels between investigators after Hp treatment(P = 0.06,T = 1.964,P = 0.053,T = 1.731)(P = 0.087,T= 1.912,P = 0.059).The levels of HDL,LDL,FPG,FINS and HOMA-IR in serum of investigators after Hp eradication were statistically significant(P <0.05)= 14.851,P =0.000,T = 10.694,P = 0.000,T = 3.210,P = 0.002 T = 10.281,P = 0.000,Z =-7.357,P= 0.000).6.Comparison of liver fat content(ultrasonography,liver fat content formula)before and after eradication of HpThere was no significant difference in liver fat content between the two groups after treatment with Hp(Z =-1.934,P = 0.053).The liver fat content of the investigators after6 days of eradication of Hpwas statistically significant(Z =-7.473,P = 0.000).Conclusion:1.Eradication of Helicobacter pylori(Hp)can reduce liver fat content in patientswith nonalcoholic fatty liver disease(NAFLD).2.Eradication of Hp is not only conducive to improving the clinical symptoms of NAFLD patients,such as abdominal pain,abdominal distension,acid reflux,nausea and vomiting,tired of greasy,loss of appetite,fatigue,also can reduce fasting blood glucose,fasting insulin and insulin resistance Level,which is associated metabolic complications,such as the treatment of type 2 diabetes to explore a new way.3.Eradication of Hp can improve the serum anti-atherogenic factor high density lipoprotein(HDL-C)levels in patients with NAFLD,and can reduce serum low density lipoprotein(LDL-C),which provides a valuable clue in prevention and treatment of NAFLD-related cardiovascular and cerebrovascular complications.4.The calculation formula of liver fat content can be used as a short-term follow-up treatment of NAFLD patients,which is convenient and effective quantitative calculation of liver fat content.5.Eradication of Helicobacter pylori(Hp)can not change the waist circumference(WC),body mass(BMI),alanine aminotransferase(AST),aspartate aminotransferase(ALT),triglyceride(TG)and cholesterol(TC)of NAFLD in the short term(within 6 months).