Is Eradicating H. pylori a Metabolic Tool?

Review by Prof. Angela Carbajal (Peru)

Study Summary 

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become one of the most common chronic liver diseases worldwide, but the role of Helicobacter pylori in its development has remained uncertain. In this large cross-sectional study of 28,624 adults, the authors examined whether H. pylori infection contributes to metabolic dysfunction and increases the risk of MASLD. Individuals who tested positive for H. pylori showed higher glucose, triglycerides, total cholesterol, LDL (low-density lipoprotein), BMI (body mass index), blood pressure, and a greater prevalence of MASLD. HDL (high-density lipoprotein), appeared protective. These associations were particularly marked in older adults and those who were overweight or obese.

These findings provide a clearer understanding of how H. pylori may interact with metabolic health and liver fat accumulation. While the study population was from a single region in China, the consistency of the metabolic alterations suggests a biologically plausible link. Identifying and treating H. pylori could become a relevant consideration in MASLD prevention strategies, especially for metabolically vulnerable patients.

Commentary 

There’s something both intuitive and striking about these findings. We have long suspected that H. pylori affects more than just the stomach—this study shows just how closely it tracks with metabolic dysfunction and MASLD. Its major strength is the large sample size, though the single-center Chinese population limits global generalizability. Still, the metabolic patterns observed feel biologically consistent and hard to ignore. The real question now is practical: could identifying and treating H. pylori become part of MASLD prevention? What we need next are longitudinal, multi-country studies to determine whether eradication truly modifies metabolic risk.

Citation

https://www.wjgnet.com/1948-5182/full/v17/i10/110833.htm

Smirnova OV, Sinyakov AA, Kasparov EV. Helicobacter pylori infection as a risk factor in the development of metabolic dysfunction-associated steatotic liver disease. World J Hepatol 2025; 17:110833.

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