Table 4.

Studies Assessing the Relationship between NAFLD and H. pylori

Authors	Year	Study design	Sample size	NAFLD diagnosis	H. pylori diagnosis	Significant findings
Abdel-Razik et al. [92]	2018	Cohort; multi-center	369 adults without NAFLD	Ultrasound	Fecal antigen	-the presence of H. pylori was an independent risk variable for the presence of NAFLD
						-After therapy of H. pylori infection, there was a significant reduction in NAFLD-LFS
Kang et al.	2018	Retrospective; NHANES data	5,404 patients	Ultrasound	H. pylori serology	-H. pylori infection was significantly associated with NAFLD in non-Hispanic black patients
						-CagA negative H. pylori was associated with an increased risk for NAFLD in the non-Hispanic white and non-Hispanic black populations
Alvarez et al.	2020	Cross-sectional; community	424 patients	Fatty Liver Index and Hepatic Steatosis Index	H. pylori multiplex serology	-No significant associations between H. pylori, H. bilis, or H. hepaticus and NAFLD or other metabolic or liver conditions
						-Seropositivity for H. pylori antigens, CagA and VacA, and H. hepaticus antigen HH0713 were each associated with a 2 to 3-fold increased prevalence of NAFLD

NAFLD, nonalcoholic fatty liver disease; H. pylori, Helicobacter pylori; LFS, liver fibrosis score, CagA, cytotoxin associated gene A; VacA, vacuolating cytotoxin A; H. bilis, Helicobacter bilis; H. hepaticus, Helicobacter hepaticus; NHANES, National Health and Nutrition Examination Survey.