关键词: 细胞毒力基因A, 幽门螺杆菌, 白细胞衍生趋化因子2, 同型半胱氨酸, 非酒精性脂肪性肝, 严重程度

Abstract: Objective To explore the correlation between cell virulence gene A (CagA), Helicobacter pylori (Hp) infection and the severity of non-alcoholic fatty liver disease (NAFLD). Methods 104 NAFLD patients treated in our hospital from January 2022 to April 2025 were selected as the observation group. According to ultrasound grading, there were 65 mild patients and 39 moderate to severe patients; at the same time, 104 healthy examinees were selected as the control group. The differences in Hp infection, CagA genotype Hp infection, and leukocyte derived chemokine 2 (LECT2), homocysteine (Hcy) levels between the observation group and the control group were compared, as well as the differences in Hp infection and severity among patients in the observation group, and the value of CagA genotype Hp infection in predicting moderate to severe lesions were analyzed. Results The Hp infection rate, CagA genotype Hp infection rate, LECT2 and Hcy in the observation group were 63.46%, 43.27%, 38.50 (29.80, 45.50) ng/mL and (18.29 ± 5.23) mmol/L, respectively, which were higher than those in the control group (P<0.05). Among Hp-infected patients, the LECT2 and Hcy levels in patients with CagA genotype Hp-infected patients were 42.30 (36.50, 50.10) ng/mL and (19.81 ± 4.10) mmol/L, respectively, which were higher than those in patients with non CagA genotype Hp-infected (P<0.05). In the observation group, the infection rates of CagA genotype Hp, LECT2, and Hcy in patients with moderate-to-severe NAFLD were 56.41%, 40.20 (38.50, 46.60) ng/mL, and (20.24 ± 3.65) mmol/L, respectively, in severe patients, which were higher than those in mild patients (P<0.05). CagA genotype Hp infection was positively correlated with severity (r_s=0.562, respectively), P<0.05). CagA genotype Hp infection is positively correlated with LECT2 and Hcy (r_s=0.384 and 0.391, respectively), P<0.05). The area under the ROC curve of Hp infection with CagA genotype for predicting moderate to serve NAFLD was 0.605 (95% CI: 0.492~0.718), with P>0.05. Conclusion The infection rate of CagA genotype Hp and the levels of LECT2 and Hcy were significantly increased in NAFLD patients, and the three were positively correlated with the severity of hepatic steatosis. At the same time, there was a positive correlation between CagA genotype Hp infection and LECT2 and Hcy levels.

Key words: Cell virulence gene A, Helicobacter pylori, Leukocyte derived chemokine 2, Homocysteine, Non alcoholic fatty liver disease, Severity