Prevalence and risk factors associated with metabolic dysfunction-associated steatohepatitis in patients with Helicobacter pylori infection: A population-based study

Rashid Abdel-Razeq; Lynn Bitar; Elio R Bitar; Chidera Onwuzo; Mohamad-Noor Abu-Hammour; Barish Eren; Islam Mohamed; Adejoke Johnson; Antoine Boustany; Somtochukwu Onwuzo; Imad Asaad

doi:10.4254/wjh.v16.i10.1169

Prevalence and risk factors associated with metabolic dysfunction-associated steatohepatitis in patients with Helicobacter pylori infection: A population-based study

World J Hepatol. 2024 Oct 27;16(10):1169-1176. doi: 10.4254/wjh.v16.i10.1169.

Authors

Affiliations

¹ Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, United States. [email protected].
² Faculty of Medicine, Saint Joseph University of Beirut, Beirut 1104 2020, Lebanon.
³ Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
⁴ Department of Medicine & Surgery, General Hospital Lagos Island, Lagos Island 101223, Lagos, Nigeria.
⁵ Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, United States.
⁶ Department of Internal Medicine, Jacobi Medical Center/North Central Bronx Hospital, Bronx, NY 10461, United States.
⁷ Division of Gastroenterology, Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, United States.
⁸ Department of Gastroenterology, Allegheny General Hospital, Pittsburgh, PA 15212, United States.
⁹ Department of Gastroenterology, Firelands Health, Sandusky, OH 44870, United States.

Abstract

Background: Helicobacter pylori (H. pylori) is associated with the development of gastrointestinal disorders ranging from gastritis to gastric cancer. The evidence of the association between metabolic dysfunction-associated steatohepatitis (MASH) and H. pylori infection in the literature is scarce. Therefore, we aim to evaluate the risk of developing MASH in patients who have had a diagnosis of H. pylori infection independently of any confounding variables.

Aim: To evaluate the risk of developing MASH in patients who have had a diagnosis of H. pylori infection.

Methods: This study used a validated multicenter research database of over 360 hospitals across 26 healthcare systems across the United States from 1999 to 2022. Multivariate regression analysis assessed the risk of developing MASH, adjusting for confounders including H. pylori infection, obesity, type 2 diabetes, hypertension, dyslipidemia, and male gender. A two-sided P value < 0.05 was considered as statistically significant, and all statistical analyses were performed using R version 4.0.2 (R Foundation for Statistical Computing, Vienna, Austria, 2008).

Results: A total of 79476132 individuals were screened in the database and 69232620 were selected in the final analysis after accounting for inclusion and exclusion criteria. Smokers (14.30%), patients with hyperlipidemia (70.35%), hypertension (73.86%), diabetes mellitus type 2 (56.46%), and obese patients (58.15%) were more common in patients with MASH compared to control. Using a multivariate regression analysis, the risk of MASH was increased in diabetics [odds ratio (OR): 3.55; 95%CI: 3.48-3.62], obese (OR: 5.93; 95%CI: 5.81-6.04), males (OR: 1.49; 95%CI: 1.46-1.52), individuals with hyperlipidemia (OR: 2.43; 95%CI: 2.38-2.49) and H. pylori infection (OR: 2.51; 95%CI: 2.31-2.73).

Conclusion: This is the largest population-based study in the United States illustrating an increased prevalence and odds of developing MASH in patients with H. pylori infection after adjusting for risk factors.

Keywords: Cirrhosis; Helicobacter Pylori; Liver; Metabolic dysfunction-associated steatohepatitis; Metabolic dysfunction-associated steatotic liver disease.