Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2024; 16(10): 1169-1176
Published online Oct 27, 2024. 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
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
Rashid Abdel-Razeq, Mohamad-Noor Abu-Hammour, Barish Eren, Islam Mohamed, Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, United States
Lynn Bitar, Faculty of Medicine, Saint Joseph University of Beirut, Beirut 1104 2020, Lebanon
Elio R Bitar, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
Chidera Onwuzo, Department of Medicine & Surgery, General Hospital Lagos Island, Lagos Island 101223, Lagos, Nigeria
Adejoke Johnson, Department of Internal Medicine, Jacobi Medical Center/North Central Bronx Hospital, Bronx, NY 10461, United States
Antoine Boustany, Division of Gastroenterology, Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, United States
Somtochukwu Onwuzo, Department of Gastroenterology, Allegheny General Hospital, Pittsburgh, PA 15212, United States
Imad Asaad, Department of Gastroenterology, Firelands Health, Sandusky, OH 44870, United States
Author contributions: Abdel-Razeq R, Onwuzo S and Boustany A designed the research study; Abdel-Razeq R, Onwuzo S, Bitar L, Bitar ER, Onwuzo C, Abu-Hammour MN, Mohamed I, Johnson A and Eren B ;contributed to the writing of the manuscript and critically revised the draft for important intellectual content; Boustany A performed the statistical analysis and interpreted the data; Asaad I supervised and reviewed manuscript for accuracy and completeness; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest regarding the publication of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rashid Abdel-Razeq, MD, Doctor, Department of Internal Medicine, Cleveland Clinic Foundation, 18101 Lorain Avenue, Cleveland, OH 44111, United States. abdelr3@ccf.org
Received: May 31, 2024
Revised: September 3, 2024
Accepted: September 23, 2024
Published online: October 27, 2024
Processing time: 143 Days and 3.7 Hours
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: Metabolic dysfunction-associated steatohepatitis; Metabolic dysfunction-associated steatotic liver disease; Helicobacter Pylori; Cirrhosis; Liver

Core Tip: Helicobacter pylori (H. pylori) is associated with the development of several 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. In this study, we evaluate the risk of developing MASH in patients who have had a diagnosis of H. pylori infection independently of any confounding variables. A validated multicenter and research platform database of more than 360 hospitals from 26 different healthcare systems across the United States from 1999 to September 2022 was utilized to construct this study.