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Nonalcoholic fatty liver disease (NAFLD) emerges as an important global burden and  Helicobacter pylori  infection ( Hp -I) has been suggested as a risk  factor of  NAFLD, although controversy exists. This retrospective study aimed to investigate a potential impact of active  Hp -I on NAFLD severity in morbidly obese patients, subjected to bariatric surgery and gastric biopsy for documentation of  Hp -I. Of 64 eligible participants, 15 (23.4%) were diagnosed with active  Hp -I, showing higher rates of nonalcoholic steatohepatitis (NASH) than those without  Hp -I (86.7% vs. 26.5%, respectively;  p  < 0.001). Concerning histological lesions, steatosis grade ( p  = 0.027), ballooning ( p  < 0.001), lobular inflammation ( p  = 0.003), and fibrosis stage ( p  < 0.001) were also more severe in  Hp -I positive patients. Likewise, liver function tests, insulin resistance, dyslipidemia, and arterial hypertension were significantly higher in  Hp -I positive patients.  Hp -I was independently positively associated with NASH (beta = 3.27;  p  = 0.002), severe NASH (beta = 2.37;  p  = 0.018), and the presence of fibrosis (beta = 3.86;  p  = 0.001) in a binary regression model, after adjustment for potential confounders. In conclusion, active  Hp -Ι was independently associated with NASH and fibrosis, findings offering potential clinical implication.

Active Helicobacter pylori Infection is Independently Associated with Nonalcoholic Steatohepatitis in Morbidly Obese Patients