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Updated: Jun 12, 2025
Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis
Published on: March 11, 2017
The interplay between Helicobacter pylori infection and rs738409 PNPLA3 in metabolic dysfunction-associated steatotic
Facundo Maiorana1, Magali Neschuk1, María Virginia Caronia1
1Laboratorio de Biotecnología Molecular (BIOTECMOL), Instituto de Biotecnología de Misiones "Dra. María Ebbe Reca" (InBioMis), Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Misiones, Argentina.
Background:
Recent studies have suggested an association between H. pylori and metabolic-disfunction associated fatty liver disease (MASLD). However, epidemiologic studies have yielded inconsistent results. We aim to evaluate the association of H. pylori and G-allele PNPLA3 in MASLD diagnosis, and markers of severity.
Methods:
A multi-center cross-sectional study was conducted. A total 224 functional dyspepsia (FD) patients cohort who underwent gastroscopy was selected. Biochemical, clinical parameters, ultrasound, FIB-4 score, LSM by VCTE, gastric biopsies, H. pylori status, and rs738409 PNPLA3 were evaluated. A second retrospective cohort of 86 patients with biopsy-proven MASLD who underwent gastroscopy with gastric biopsies was analyzed.
Results:
In the FD cohort MASLD was observed in 52%, and H. pylori-positive in 51%. H. pylori infection was associated with MASLD prevalence, but in multivariate analyses adjusted for G-allele PNPLA3, it became not significant. Then in MASLD-only dyspeptic cohort, H. pylori infection was significantly linked to elevated serum AST levels and increased liver stiffness measurements, suggesting a potential role in liver injury and fibrosis. Histopathological analysis in biopsy-proven MASLD patients further supported these findings, showing a significant association between H. pylori infection and increased NAS score, fibrosis stage, and prevalence of MASH. Notably, the combination of H. pylori infection and G-allele PNPLA3 appeared to exacerbate MASLD severity beyond individual effects.
Conclusions:
Our results suggest that H. pylori infection may play a role in the progression of liver injury and fibrosis in patients with MASLD, especially in those with specific genetic predispositions.
Insights
Helicobacter pylori infection may worsen metabolic dysfunction-associated fatty liver disease (MASLD) progression, particularly in individuals with the PNPLA3 gene variant. This suggests H. pylori contributes to liver injury and fibrosis in MASLD patients.
Area of Science:
- Hepatology
- Gastroenterology
- Genetics
Background:
- Growing evidence suggests a link between H. pylori and metabolic dysfunction-associated fatty liver disease (MASLD).
- Previous epidemiological studies on this association have produced conflicting results.
- This study investigates the roles of H. pylori and the PNPLA3 G-allele in MASLD diagnosis and severity.
Purpose of the Study:
- To evaluate the association between H. pylori infection and MASLD.
- To assess the combined impact of H. pylori and the PNPLA3 G-allele on MASLD severity.
- To explore H. pylori's role in liver injury and fibrosis markers in MASLD patients.
Main Methods:
- A multi-center cross-sectional study involving 224 functional dyspepsia patients.
- Evaluation of clinical, biochemical, and histopathological parameters, including H. pylori status and PNPLA3 rs738409 genotype.
- Analysis of a secondary retrospective cohort of 86 biopsy-proven MASLD patients.
Main Results:
- H. pylori infection was linked to MASLD prevalence in the functional dyspepsia cohort, but this lost significance after adjusting for the PNPLA3 G-allele.
- In MASLD patients, H. pylori correlated with elevated AST, increased liver stiffness, higher NAS scores, and advanced fibrosis.
- The combination of H. pylori and the PNPLA3 G-allele showed a synergistic effect on MASLD severity.
Conclusions:
- H. pylori infection may contribute to liver injury and fibrosis progression in MASLD.
- Genetic predisposition, specifically the PNPLA3 G-allele, may modulate the impact of H. pylori on MASLD.
- These findings highlight the complex interplay between infection, genetics, and liver disease progression.
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