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Effect of helicobacter pylori-eradication therapy on hepatic steatosis in patients with non-alcoholic fatty liver disease:a randomized–controlled pilot study

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Gastroenterology Report 2020年第2期8卷 104-110,I0001,I0002页

作者： Vikas Maharshi Pooja Gupta Vijay L.Kumar Ashish Datt Upadhyay Prasenjit Das Rajni Yadav Baibaswata Nayak Ramesh Kumar Shalimar Department of Pharmacology All India Institute of Medical SciencesNew DelhiIndia Department of Biostatistics All India Institute of Medical SciencesNew DelhiIndia Department of Pathology All India Institute of Medical SciencesNew DelhiIndia Department of Gastroenterology All India Institute of Medical SciencesNew DelhiIndia

Background:helicobacter pylori infection has been associated with insulin resistance and non-alcoholic fatty liver disease(NAFLD).This study was done to evaluate the effect of ***-eradication therapy(hPET)in patients with NAFLD compared to standard management therapy(SMT).Methods:Eighty NAFLD patients with *** co-infection were randomized into SMT(diet and exercise,n=36)and hPET(SMT plus amoxicillin,clarithromycin,and pantoprazole,n=44)*** controlled attenuation parameter(CAP),anthropometric parameters,liver enzymes,lipid profile,and glycemic parameters including homeostasis model assessment-insulin resistance(hOMA-IR)were measured and compared between two groups at the baseline and 24 ***:Sixty-four participants(SMT group[n=28]and hPET group[n=36])were included in amodified intention-to-treat *** the SMT group and the hPET group had a significant reduction in CAP scores at 24weeks(P=0.002 and Phe change between the groups was insignificant(P=0.213).Successful eradication of *** occurred in 68%of the hPET group and led to greater improvement in hOMA-IR at 24weeks compared to SMT or non-responder patients(P=0.007).The liver enzymes reduced significantly at 24weeks in both groups,but the changes between the groups were *** lipid parameters remained unchanged within the groups and between the groups at 24weeks.A significant increase in the levels of reduced glutathione was noted in the hPET group,but the change between the two groups was not statistically ***:hPET was found to be comparable to SMT alone in reducing hepatic steatosis and liver enzymes at 24 weeks in NAFLD ***,successful eradication of *** led to greater improvement in hOMA-IR(Trial registration CTRI/2017/05/008608).

关键词： non-alcoholic fatty liver disease h.pylori infection h.pylori-eradication therapy controlled attenuation parameter insulin resistance

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