幽门螺杆菌 cagA/vacAs1-m1 株与代谢功能障碍相关性脂肪肝的高纤维化风险有关。

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of hepatology Pub Date : 2024-08-29 DOI:10.1016/j.aohep.2024.101541
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引用次数: 0

摘要

引言和目的:最近的研究表明,幽门螺杆菌与代谢功能障碍相关性脂肪性肝病(MASLD)之间存在关联。我们旨在评估幽门螺杆菌毒力基因与MASLD受试者肝损伤和肝纤维化的非侵入性标记物之间的关联:患者和方法:共选取了 362 名接受胃镜检查的消化不良患者。对生化指标、临床参数、超声波、FIB-4评分、振动控制瞬态弹性成像(VCTE)肝脏硬度测量(LSM)、胃活检和幽门螺杆菌毒力基因(cagA、vacA)进行了评估:61%的患者为女性,39%为男性,中位年龄为52(40-60)岁。42%的人患有MASLD,45%的人幽门螺杆菌阳性。在幽门螺杆菌状态和合并代谢性疾病方面没有发现差异。在 MASLD 群体中,幽门螺杆菌阳性与较高的 AST、ALT、FIB-4 和 LSM 相关。事实上,cagA/vacA-s1/m1等位基因组合阳性的携带者与较高的谷草转氨酶、谷丙转氨酶、FIB-4和LSM相关,而cagA/vacA-s1/m1阴性的携带者与较高的谷草转氨酶、谷丙转氨酶、FIB-4和LSM无关。幽门螺杆菌阳性者的 VCTE(≥8kPa)显着/晚期纤维化高风险 OR 为 2.56(95% CI,1.2-5.75),cagA/vacA-s1/-m1 阳性等位基因携带者的 OR 为 4.01(95% CI,1.38-11.56),但与 cagA/vacA-s1/-m1 阴性者无显著相关性。在对年龄、性别、糖尿病、体重指数和高血压进行调整后,幽门螺杆菌阳性者VCTE≥8kPa的OR值为2.43(95% CI,1.88-12.44),cagA/vacA-s1/m1阳性等位基因携带者的OR值为4.06(95% CI,1.22-14.49):在我们的MASLD FD患者队列中,幽门螺杆菌与肝损伤和肝纤维化的非侵入性标志物有关。cagA/vacA-s1/m1等位基因组合阳性携带者在VCTE中显示出明显/晚期肝纤维化的独立风险。
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Helicobacter pylori cagA/vacAs1-m1 strain is associated with high risk of fibrosis in metabolic-dysfunction-associated steatotic liver disease

Introduction and Objectives

Recent studies have suggested an association between H. pylori and metabolic dysfunction associated steatotic liver disease (MASLD). We aim to evaluate the association of H. pylori virulence genes with non-invasive markers of liver injury and fibrosis in MASLD subjects.

Patients and Methods

A total of 362 dyspeptic patients who underwent gastroscopy were selected. Biochemical, clinical parameters, ultrasound, FIB-4 score, liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE), gastric biopsies, and H. pylori virulence genes (cagA, vacA) were evaluated.

Results

A cohort comprised of 61 % women and 39 % men with a median age of 52 (40–60) years. MASLD was observed in 42 %, and H. pylori-positive in 45 %. No differences were observed regarding H. pylori status at co-morbid metabolic conditions. In MASLD cohort, H. pylori-positive was associated with higher AST, ALT, FIB-4 and LSM. Indeed, carriers of cagA/vacA-s1/m1-positive allelic combination were associated with higher AST, ALT, FIB-4 and LSM but not cagA/vacA-s1/m1-negative. The OR for high-risk of significant/advanced- fibrosis by VCTE (≥8 kPa) with H. pylori-positive was 2.56 (95 % CI, 1.2–5.75) and for cagA/vacA-s1/-m1-positive allelic carriers was 4.01 (95 % CI, 1.38–11.56), but non-significant association in cagA/vacA-s1/-m1-negative. After adjusting for age, gender, diabetes, BMI and hypertension the OR for VCTE ≥8 kPa with H. pylori-positive was 2.43 (95 % CI, 1.88–12.44), and cagA/vacA-s1/m1-positive allelic carriers was 4.06 (95 % CI, 1.22–14.49).

Conclusions

In our cohort of functional dyspepsia (FD) patients with MASLD, H. pylori was associated with non-invasive markers of liver injury and fibrosis. Carriers of cagA/vacA-s1/m1-positive allelic combination showed an independent risk of significant/advanced fibrosis by VCTE.

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来源期刊
Annals of hepatology
Annals of hepatology 医学-胃肠肝病学
CiteScore
7.90
自引率
2.60%
发文量
183
审稿时长
4-8 weeks
期刊介绍: Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.
期刊最新文献
Editorial board Global multi-societies endorsement of the MAFLD definition An Acknowledgement Biological aging accelerates hepatic fibrosis: Insights from the NHANES 2017-2020 and genome-wide association study analysis. Development of a biodegradable prosthesis through tissue engineering, for the organ-replacement or substitution of the extrahepatic bile duct
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