Abstract: Objective To explore the association between non-alcoholic fatty liver disease (NAFLD), Helicobacter pylori(Hp) infection, and the incidence of colorectal polyps.Methods From June 2021 to May 2022, a total of 133 patients diagnosed with colorectal polyps through colonoscopy and pathological examination were included in the experimental group. This group comprised 54 cases of hyperplastic polyps and 79 cases of adenomatous polyps. Additionally, 70 patients without colorectal polyps were selected as the control group. In all patients, various parameters, including total cholesterol (CHOL), low-density lipoprotein (LDL), HP antibody, serum gastrin 17 (G-17) and pepsinogen Ⅰ(PG-Ⅰ)/ pepsinogen Ⅱ (PG-II) ratio(PGR) were measured. Binary logistic regression analysis was utilized to assess the impact of each index on the occurrence of colonic polyps. The patients were subsequently categorized into two groups: the proliferative polyp group and the adenomatous polyp group. The differences in NAFLD, gastric histopathology, HP infection, adenomatous polyps with intestinal epithelial neoplasia and seurm G-17 levels between the two groups were observed in the study.Results The occurrence of colon polyps was found to be significantly associated with being older than 60 years (χ²=7.436,P=0.006, OR=2.657), Hp infection (χ²=17.702,P<0.001, OR=4.650), PGR (χ²=10.794,P=0.001,OR=1.129) and elevated levels of serum G-17 (χ²=4.471,P=0.034, OR=3.706). In the adenomatous polyp group, the HP-positive ratio was 75.9%, significantly higher than the 59.3% in the hyperplastic group(χ²=4.190, P=0.041). Similarly, the prevalence of NAFLD in the adenoma group was 32.9%, exceeding the 14.8% in the hyperplastic group (χ²=5.520, P=0.019). The percentage of patients older than 60 years in the adenoma group was 81.0%, which was higher compared to 64.8% in the hyperplasia group (χ²=4.423, P=0.035). No significant differences were observed in the proportion of precancerous lesions (30.4%vs44.4%), the increase rate of G-17 (17.7%vs11.1%), and the level of PGR (14.18±7.74 vs 13.93±8.75) between the two groups(P>0.05). Between the advanced and non-advanced groups, there were no significant differences in the proportion of NAFLD (20.8%vs38.2%) and the increase rate of G-17 (41.7% vs 34.5%) (P>0.05). However, the smoking rate in the advanced group was 37.5%, markedly higher than 16.4% in the non-advanced group(χ²=4.243, P=0.039), and the rate of severe chronic stomach disease with precancer was 45.8% in the advanced group compared to 23.6% in the non-progressive group (χ²=3.892,P=0.049). The HP infection rate was significantly higher in the advanced group(91.7%) compared to the non-advanced group(69.1%) (χ²=4.662, P=0.031).Conclusion The development and progression of colorectal polyps, particularly adenomatous polyps, are linked to gastric precancerous lesions, Hp infection and NAFLD. Effectively treating and preventing severe chronic gastric conditions and NAFLD, as well as the comprehensive eradication of HP, hold significantly potential in both the prevention and management of colorectal polyps.

Key words: Helicobacter pylori, Non-alcoholic fatty liver disease, Colorectal polyps