目的 探讨幽门螺杆菌(Hp)感染与非酒精性脂肪性肝病(NAFLD)及糖脂代谢、血清炎症因子的关系。方法 回顾性分析2020年9月-2022年9月386例于临海市第一人民医院进行健康体检人群的临床资料，根据所选研究对象13C-尿素呼气试验结果将其分为Hp感染阳性组(124例，13C-尿素呼气试验阳性参考值≥4)、Hp感染阴性组(262例，13C-尿素呼气试验阳性参考值＜4)。比较两组一般资料、糖脂代谢、肝功能指标及炎症因子水平，并予以多因素Logistic回归分析Hp感染的危险因素。结果 Hp感染阳性组NAFLD发生率为44。35％，高于Hp感染阴性组的24。05％(P＜0。05);Hp感染阳性组全血空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2 h血糖(2 hPG)、胰岛素抵抗指数(HOMA-IR)及血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平均高于Hp感染阴性组(P＜0。05);血清高密度脂蛋白胆固醇(HDL-C)水平低于Hp感染阴性组(P＜0。05);多因素Logis-tic 回归分析结果显示，合并NAFLD、全血FPG、2 h PG、血清LDL-C、TG、IL-6、IL-10、TNF-α、IFN-γ高表达及血清HDL-C低表达是Hp感染的危险因素(P＜0。05)。结论 Hp感染与NAFLD相关，且其可引起糖脂代谢紊乱及血清炎症因子水平异常变化，临床可据此及时筛查并治疗Hp感染。
Relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease,glycolipid metabolism and serum inflammatory factors
OBJECTIVE To investigate the relationship between Helicobacter pylori(Hp)infection and non-alco-holic fatty liver disease(NAFLD),glycolipid metabolism and serum inflammatory factor.METHODS The clinical data of 386 people under physical examination in the First People's Hospital of Linhai from Sep 2020 to Sep 2022 were retrospectively analyzed.They were divided into the Hp-positive group(124 cases,13C urea breath test posi-tive reference value ≥4)and the Hp-negative group(262 cases,13C urea breath test positive reference value＜4)according to the results of 13C urea breath test.The general data,glycolipid metabolism,liver function indicators and inflammatory factors were compared between the two groups,and the risk factors for Hp infection were ana-lyzed by multifactor logistic regression.RESULTS The incidence of NAFLD in the Hp-positive group was 44.35％,which was higher than that in the Hp-negative group(24.05％,P＜0.05).The levels of fasting glucose(FPG),fasting insulin(FINS),2 hour postprandial plasma glucose(2hPPG),homeostasismodel assessment-IR(HOMA-IR)and levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),triacylglycerol(TG),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)in the Hp-positive group were higher than those in the Hp-negative group(P＜0.05);the serum level of high densi-ty lipoprotein cholesterol(HDL-C)was lower than that in the Hp-negative group(P＜0.05).Multivariate logistic regression analysis showed that NAFLD,high expression of whole blood FPG,2hPPG,serum LDL-C,TG,IL-6,IL-10,TNF-α,IFN-γ and low expression of serum HDL-C were risk factors for Hp infection(P＜0.05).CONCLUSION Hp infection was associated with NAFLD and can cause glycolipid metabolism disorders and abnor-mal changes in serum inflammatory factors,which can be reference for clinical screening and treatment of Hp in-fection timely.
Helicobacter pyloriInfectionNonalcoholic fatty liver diseaseInflammatory factorsGlycolipid me-tabolismHealthy population of physical examination13C-urea breath test
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