Effects of Helicobacter pylori Eradication on the Risk and Clinical Parameters of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis

IF 4.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2025-11-30 DOI:10.1111/hel.70092

Xiang Li, Yizhen Tao, Hangyu Li, Lisha Mai, Xindi He, Jingwen Yan, Xiao Yang

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引用次数: 0

Abstract

Background

Previous studies have established an association between Helicobacter pylori (H. pylori) infection and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the specific effects of H. pylori eradication therapy on MASLD patients remain unclear. Therefore, this systematic review and meta-analysis aims to comprehensively evaluate the impact of H. pylori eradication therapy on the incidence and clinical course of MASLD.

Materials and Methods

Cohort studies and randomized controlled trials (RCTs) were systematically retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Hazard ratios (HRs) from cohort studies and mean differences (MDs) from RCTs with their corresponding 95% confidence intervals (CIs) were calculated to assess the impact of H. pylori eradication therapy on MASLD risk and changes in laboratory parameters. Subgroup analyses were performed based on varying follow-up periods and intervention type. Sensitivity analyses were conducted to assess the robustness of the findings. Funnel plots were used to evaluate publication bias.

Results

Eight studies, including two cohort studies assessing the incidence risk and six RCTs analyzing laboratory parameters, were included, encompassing a total of 5320 participants. All eligible studies were subjected to meta-analysis of their respective outcomes. H. pylori eradication therapy was found to significantly lower the risk of developing MASLD (HR = 0.74, 95% CI: 0.65–0.85). In patients already diagnosed with MASLD, eradication therapy was associated with reductions in waist circumference (MD = −0.62, 95% CI: −1.20 to −0.03), aspartate aminotransferase (AST; MD = −2.12, 95% CI: −2.78 to −1.45), fasting blood glucose (FBG; MD = −0.33, 95% CI: −0.66 to −0.01), homeostasis model assessment of insulin resistance (HOMA-IR; MD = −0.21, 95% CI: −0.25 to −0.17).

Conclusions

The application of H. pylori eradication therapy correlates with a reduced risk of MASLD and favorable changes in anthropometric, hepatic, glycemic, and inflammatory outcomes, though these benefits may vary depending on the duration of follow-up and eradication methods.

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根除幽门螺杆菌对代谢功能障碍相关脂肪变性肝病的风险和临床参数的影响：一项系统综述和荟萃分析

背景：先前的研究已经建立了幽门螺杆菌（h.p ylori）感染与代谢功能障碍相关脂肪变性肝病（MASLD）之间的联系。然而，幽门螺杆菌根除治疗对MASLD患者的具体效果尚不清楚。因此，本系统综述和荟萃分析旨在全面评估幽门螺杆菌根除治疗对MASLD发病率和临床病程的影响。材料和方法：系统地从PubMed、Embase、Cochrane图书馆和Web of Science检索队列研究和随机对照试验（RCTs）。计算队列研究的风险比（hr）和随机对照试验的平均差异（MDs）及其相应的95%置信区间（ci），以评估幽门螺杆菌根除治疗对MASLD风险和实验室参数变化的影响。根据不同的随访期和干预类型进行亚组分析。进行敏感性分析以评估研究结果的稳健性。采用漏斗图评价发表偏倚。结果：纳入8项研究，包括2项评估发病风险的队列研究和6项分析实验室参数的随机对照试验，共纳入5320名参与者。所有符合条件的研究对各自的结果进行荟萃分析。发现根除幽门螺杆菌治疗可显著降低发生MASLD的风险（HR = 0.74, 95% CI: 0.65-0.85）。在已经诊断为MASLD的患者中，根除治疗与腰围（MD = -0.62, 95% CI: -1.20至-0.03）、天冬氨酸转氨酶（AST; MD = -2.12, 95% CI: -2.78至-1.45）、空腹血糖（FBG; MD = -0.33, 95% CI: -0.66至-0.01）、胰岛素抵抗稳态模型评估（HOMA-IR; MD = -0.21, 95% CI: -0.25至-0.17）的减少相关。结论：幽门螺杆菌根除治疗的应用与MASLD的风险降低以及人体测量、肝脏、血糖和炎症结果的有利变化相关，尽管这些益处可能因随访时间和根除方法而异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.