The association between H. Pylori and MASLD disease incidence and severity: A cross-sectional study

Background: One of the most common chronic liver disorders in the world, non-alcoholic fatty liver disease (NAFLD), poses a significant public health concern. Excessive lipid accumulation in hepatocytes, in the absence of substantial alcohol consumption or other secondary factors, defines it. Aim: This study aimed to examine the relationship between Helicobacter pylori (H. pylori) infection and the severity of non-alcoholic fatty liver disease (NAFLD), which has recently been termed metabolic dysfunction-associated steatotic liver disease (MASLD).Patients and Methods: A cross-sectional study was conducted at the outpatient clinics of Ain Shams University Hospitals between January 2023 and July 2023. Ninety adult patients with ultrasound-confirmed NAFLD were enrolled. Clinical, anthropometric, and laboratory data were collected for all participants. Disease severity was assessed using the fatty liver index (FLI), NAFLD fibrosis score, and Fibrosis-4 (FIB-4) index. H. pylori infection status was determined using stool antigen testing.Results: The mean age of the patients studied was 44.7 ± 9.8 years, with females comprising 71.1% of the cohort. H. pylori infection was detected in 57.8% of patients. Comparative analysis revealed no statistically significant differences between H. pylori–positive and –negative groups regarding FLI (p = 0.405), NAFLD fibrosis score (p = 0.457), or FIB-4 index (p = 0.300). NAFLD severity was significantly correlated with age, body mass index, waist circumference, platelet count, serum albumin, and liver enzyme levels, but not with H. pylori infection status. Conclusion: Although H. pylori infection was highly prevalent among patients with NAFLD, it was not significantly associated with disease severity. Further longitudinal studies are required to clarify potential causal relationships.