H. pylori bacteria linked to obesity and fatty liver disease

Is H. pylori Infection the Missing Link in Obesity and Fatty Liver Disease?

Lena Voss in Health & Wellness December 2025 • 4 min read.

"New research sheds light on the connection between H. pylori, obesity, and non-alcoholic fatty liver disease (NAFLD), offering potential insights for prevention and treatment."

The global rise in obesity and non-alcoholic fatty liver disease (NAFLD) has become a major public health concern. While factors like diet and lifestyle are known contributors, recent research suggests a potential link between Helicobacter pylori (H. pylori) infection and these metabolic disorders. This connection could offer new avenues for understanding, preventing, and treating these increasingly prevalent conditions.

NAFLD, affecting both lean and obese individuals, shares a common altered metabolic and cardiovascular profile, similar to that observed in traditional metabolic syndrome. This has prompted researchers to investigate underlying mechanisms, with H. pylori infection emerging as a potential player.

H. pylori, a bacterium commonly found in the stomach, has been linked to various health issues, including peptic ulcers and gastric cancer. However, its potential role in metabolic syndrome, insulin resistance, and related conditions like NAFLD is gaining increasing attention. Given the widespread prevalence of both H. pylori infection and metabolic syndrome, understanding this link could have significant implications for global health.

The H. pylori and Metabolic Syndrome Connection: Unpacking the Evidence

H. pylori bacteria linked to obesity and fatty liver disease

Evidence suggests a probable association between H. pylori infection and insulin resistance, a key feature of metabolic syndrome. This connection extends to various related morbidities, including NAFLD, abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, and cardiovascular disease – the ultimate endpoint of metabolic syndrome.

Both H. pylori infection and metabolic syndrome are incredibly common worldwide. The increasing prevalence of metabolic syndrome mirrors the ongoing epidemics of obesity and type 2 diabetes. While metabolic syndrome shortens lifespan, primarily through type 2 diabetes, cardiovascular disease, and certain cancers, H. pylori infection remains highly prevalent in many regions, including South and East Europe, South America, and Asia.

Impaired Ghrelin Production: H. pylori infection can impair gastric ghrelin production, a hormone that regulates appetite and energy balance.
Increased Inflammation: Studies have shown that NAFLD patients with H. pylori infection have higher levels of anti-H. pylori IgG and tumor necrosis factor (TNF)-α, indicating increased inflammation.
Cardiovascular Risk: H. pylori infection has been linked to increased levels of fibrinogen, an independent risk factor for cardiovascular disease.

Researchers suggest that H. pylori-related metabolic syndrome could also influence the pathophysiology of cardio-cerebrovascular diseases through mechanisms like TNF-α involvement in atherosclerosis and atrial fibrillation-related stroke. This highlights the systemic impact of H. pylori infection beyond the gastrointestinal tract.

The Potential Benefits of H. pylori Eradication

Eradicating H. pylori infection offers several potential benefits: it can decrease fibrinogen levels, increase high-density lipoprotein-cholesterol, decrease C-reactive protein levels, improve NAFLD fibrosis score and HSENSI (homocysteine, serum glutamic oxaloacetic transaminase, erythrocyte sedimentation rate, non-alcoholic steatohepatitis index), and improve homoeostatic model assessment and insulin resistance. By inhibiting prothrombotic and proinflammatory agents, H. pylori eradication might positively affect H. pylori-related NAFLD and CVD development/progression and benefit metabolic syndrome-related morbidity. These findings suggest that H. pylori infection as a risk factor for NAFLD, appears to be a common denominator underlying the shared altered metabolic syndrome and cardiovascular profile between lean and obese patients. Its eradication might benefit the aforementioned profile, and these findings merit further investigation.

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Everything You Need To Know

What is the connection between H. pylori and Non-Alcoholic Fatty Liver Disease (NAFLD)?

Research suggests a potential link between Helicobacter pylori (H. pylori) infection and Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD shares a common altered metabolic and cardiovascular profile, similar to that observed in traditional metabolic syndrome. Studies indicate that NAFLD patients with H. pylori infection have higher levels of anti-H. pylori IgG and tumor necrosis factor (TNF)-α, indicating increased inflammation. The presence of H. pylori can influence the pathophysiology of cardio-cerebrovascular diseases through mechanisms such as TNF-α involvement in atherosclerosis and atrial fibrillation-related stroke. This highlights the systemic impact of H. pylori infection beyond the gastrointestinal tract. Furthermore, eradicating H. pylori infection might improve NAFLD fibrosis score and HSENSI (homocysteine, serum glutamic oxaloacetic transaminase, erythrocyte sedimentation rate, non-alcoholic steatohepatitis index), suggesting a direct impact on the disease.

How does H. pylori infection contribute to metabolic syndrome and cardiovascular risk?

Helicobacter pylori (H. pylori) infection has been linked to metabolic syndrome through its association with insulin resistance. This connection extends to various related morbidities, including NAFLD, abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, and cardiovascular disease. Moreover, H. pylori infection can impair gastric ghrelin production, a hormone that regulates appetite and energy balance. It is also linked to increased inflammation, as evidenced by higher levels of anti-H. pylori IgG and TNF-α in NAFLD patients. H. pylori infection has been linked to increased levels of fibrinogen, an independent risk factor for cardiovascular disease, highlighting the systemic impact of the infection. These factors contribute to the pathophysiology of cardio-cerebrovascular diseases through mechanisms like TNF-α involvement in atherosclerosis and atrial fibrillation-related stroke.

What are the potential benefits of eradicating H. pylori infection?

Eradicating Helicobacter pylori (H. pylori) infection offers several potential benefits. It can decrease fibrinogen levels, increase high-density lipoprotein-cholesterol, decrease C-reactive protein levels, and improve the NAFLD fibrosis score and HSENSI (homocysteine, serum glutamic oxaloacetic transaminase, erythrocyte sedimentation rate, non-alcoholic steatohepatitis index). Additionally, it can improve homoeostatic model assessment and insulin resistance. By inhibiting prothrombotic and proinflammatory agents, H. pylori eradication might positively affect H. pylori-related NAFLD and cardiovascular disease (CVD) development/progression and benefit metabolic syndrome-related morbidity. These findings suggest that H. pylori eradication could be a beneficial intervention for those with metabolic syndrome.

How does H. pylori infection affect appetite and energy balance?

Helicobacter pylori (H. pylori) infection can impair gastric ghrelin production. Ghrelin is a hormone that regulates appetite and energy balance. By disrupting ghrelin production, H. pylori infection may contribute to metabolic imbalances and potentially influence the development of obesity. This impaired production can affect the body's ability to regulate hunger and satiety signals, leading to altered eating patterns and potential weight gain. This impact is another way that H. pylori can contribute to metabolic disorders.

Why is the link between H. pylori infection and metabolic syndrome significant for global health?

The link between Helicobacter pylori (H. pylori) infection and metabolic syndrome is significant for global health because both are incredibly common worldwide. The increasing prevalence of metabolic syndrome mirrors the ongoing epidemics of obesity and type 2 diabetes. Given the widespread prevalence of both H. pylori infection and metabolic syndrome, understanding this link could have significant implications for global health. H. pylori infection has been linked to insulin resistance, NAFLD, abdominal obesity, type 2 diabetes mellitus, dyslipidemia, hypertension, and cardiovascular disease. Moreover, H. pylori-related metabolic syndrome could also influence the pathophysiology of cardio-cerebrovascular diseases. Addressing H. pylori could offer new avenues for understanding, preventing, and treating these increasingly prevalent conditions, which could lead to improved health outcomes on a global scale.