P3805 - Patients With NAFLD Are at an Increased Risk of Helicobacter pylori Infections: Results From National Inpatient Sample Analysis

Shivam Kalra, MBBS¹, Aalam Sohal, MD², Hunza Chaudhry, MD³, Jay Patel, MD⁴, Ishandeep Singh, MBBS⁵, Isha Kohli, MBBS, CPH, MPH⁶, Kanwal Bains, MBBS, CNSC⁷, Dino Dukovic, BS⁸, Marina Roytman, MD^9
1Trident Medical Center, Charleston, SC; ²Liver Institute Northwest, Seattle, WA; ³University of California San Francisco, Fresno, CA; ⁴Orange Park Medical Center, Jacksonville, FL; ⁵Dayanand Medical College and Hospital, Ludhiana, Punjab, India; ⁶Icahn School of Medicine at Mount Sinai, New York, NY; ⁷University of Arizona, Tucson, AZ; ⁸Ross University School of Medicine, Maramar, FL; ⁹UCSF Fresno, Fresno, CA

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Studies have reported an association between NAFLD and changes in the gut microbiome. H.pylori infection has also been observed to be a factor in the development of insulin resistance and non-alcoholic fatty liver disease. The current study aims to assess the relationship between the presence of NAFLD and the risk of Helicobacter pylori (HP) infection.

Methods: National Inpatient Sample (NIS) database 2020 was used to stratify patients based on the presence of HP infection. Information was collected regarding patient demographics, hospital characteristics, Charlson comorbidity index, coexisting comorbidities (GERD, hyperlipidemia, tobacco use, diabetes, hypertension, obesity, obstructive sleep apnea(OSA), and inflammatory bowel disease (IBD)) as well as HP. Univariate and Multivariate analysis was performed to identify the relationship between NAFLD and HP infections after adjusting for confounding factors.

Results: Out of 26 million patients, 24,910 patients had concomitant HP infection. The majority of the patients in the HP infection group were aged >65 years (46.1%), female (45.4%), had Medicare (41.9%) and were in the lowest income quartile (38.6%). There was a higher prevalence of NAFLD in patients with HP infection than those without (5.9% vs 2.9%, p< 0.001). There was a higher incidence of GERD, diabetes, and hypertension in the HPI group than those without (Table 1). After adjusting for confounding factors, the relationship between NAFLD and HP infection was noted to be statistically significant (aOR-1.58, 95% CI-1.41-1.79, p< 0.001). Other factors noted to be associated with HP infection included IBD, celiac disease, male gender, racial factors, and IBS. Diabetes, OSA, and obesity were noted to be associated with a reduced risk of HP infection (Figure 1).

Discussion: Our study demonstrated a notable increase in the risk of HP infections in patients with NAFLD. Since the data is cross-sectional, it is difficult to ascertain if HP infection is the cause or effect of NAFLD. Previous studies have noted a bidirectional relationship. Our study builds up on the previous data, and it is likely that these patients have microbiome alterations predisposing them to developing HP infections. Further prospective studies are needed to identify the causal relationship between these two conditions.



Disclosures:


Shivam Kalra, MBBS¹, Aalam Sohal, MD², Hunza Chaudhry, MD³, Jay Patel, MD⁴, Ishandeep Singh, MBBS⁵, Isha Kohli, MBBS, CPH, MPH⁶, Kanwal Bains, MBBS, CNSC⁷, Dino Dukovic, BS⁸, Marina Roytman, MD⁹. P3805 - Patients With NAFLD Are at an Increased Risk of Helicobacter pylori Infections: Results From National Inpatient Sample Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.