{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:34:05Z","timestamp":1786700045605,"version":"build-2736575974"},"reference-count":87,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a systemic cardiometabolic disorder arising from the convergence of metabolic stress, chronic low-grade (smoldering) inflammation, and vascular pathology. MASLD extends beyond hepatic fat accumulation, and is tightly linked to arterial hypertension and cardiovascular disease, with arterial hypertension acting as a disease modifier that accelerates fibrosis progression and deteriorates long-term outcomes. Emerging evidence suggests that chronic infections, particularly Helicobacter pylori infection, may further amplify this cardiometabolic continuum by sustaining inflammatory signaling, oxidative stress, insulin resistance, and endothelial damage. These mechanisms substantially overlap with crucial pathogenic pathways implicated in MASLD progression and hypertension onset. At the molecular level, AMP-activated protein kinase (AMPK) signaling represents a key integrative axis linking energy homeostasis, inflammation, and blood pressure regulation. Pharmacological AMPK activation, exemplified by imeglimin targeting presenilin enhancer-2, highlights the translational potential of therapies addressing hepatic and vascular injury simultaneously. This perspective summarizes clinical and mechanistic evidence supporting an integrated, systems-based framework in which chronic infection and metabolic stress converge along a shared axis to drive hypertension and MASLD. It underscores the need to incorporate metabolic regulation, cardiovascular risk modification, and selected infectious determinants into future risk stratification models and therapeutic strategies.<\/jats:p>","DOI":"10.1093\/ajh\/hpag064","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:23:58Z","timestamp":1782127438000},"page":"1045-1054","source":"Crossref","is-referenced-by-count":0,"title":["Chronic infection and metabolic stress: a converging axis driving hypertension and metabolic dysfunction-associated steatotic liver disease outcomes"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-5136","authenticated-orcid":false,"given":"Jannis","family":"Kountouras","sequence":"first","affiliation":[{"name":"Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki, Macedonia,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9232-4042","authenticated-orcid":false,"given":"Stergios A","family":"Polyzos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki, Macedonia,","place":["Greece"]},{"name":"First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki , Thessaloniki, Macedonia,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3698-9135","authenticated-orcid":false,"given":"Elisabeth","family":"Vardaka","sequence":"additional","affiliation":[{"name":"Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki, Macedonia,","place":["Greece"]},{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University , Thessaloniki,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3443-7791","authenticated-orcid":false,"given":"Christos","family":"Zavos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki, Macedonia,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-5081","authenticated-orcid":false,"given":"Michael","family":"Doulberis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki, Macedonia,","place":["Greece"]},{"name":"Department of Gastroenterology & Hepatology, University Hospital Zurich, University of Zurich , Zurich,","place":["Switzerland"]},{"name":"Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau , Aarau,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"2026081404470613400_hpag064-B1","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1038\/s41591-019-0675-0","article-title":"Chronic inflammation in the etiology of disease across the life span","volume":"25","author":"Furman","year":"2019","journal-title":"Nat Med."},{"key":"2026081404470613400_hpag064-B2","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1038\/nature01323","article-title":"Inflammation in atherosclerosis","volume":"420","author":"Libby","year":"2002","journal-title":"Nature."},{"key":"2026081404470613400_hpag064-B3","doi-asserted-by":"crossref","DOI":"10.1097\/HC9.0000000000000586","article-title":"Serum protein risk stratification score for diagnostic evaluation of metabolic dysfunction-associated steatohepatitis","volume":"8","author":"Lai","year":"2024","journal-title":"Hepatol Commun."},{"key":"2026081404470613400_hpag064-B4","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.cmet.2024.03.011","article-title":"New and emerging treatments for metabolic dysfunction-associated steatohepatitis","volume":"36","author":"Tincopa","year":"2024","journal-title":"Cell Metab."},{"key":"2026081404470613400_hpag064-B5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","article-title":"EASL-EASD-EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)","volume":"81","author":"European Association for the Study of the Liver (EASL)","year":"2024","journal-title":"J Hepatol"},{"key":"2026081404470613400_hpag064-B6","doi-asserted-by":"crossref","first-page":"502","DOI":"10.36660\/abc.20210931","article-title":"Impact of active Helicobacter pylori infection-related metabolic syndrome on systemic arterial hypertension","volume":"119","author":"Kountouras","year":"2022","journal-title":"Arq Bras Cardiol."},{"key":"2026081404470613400_hpag064-B7","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/ajh\/hpac120","article-title":"Potential impact of Helicobacter pylori-related metabolic syndrome on arterial hypertension outcomes","volume":"36","author":"Kountouras","year":"2023","journal-title":"Am J Hypertens."},{"key":"2026081404470613400_hpag064-B8","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.tcm.2025.01.001","article-title":"Metabolic dysfunction-associated steatotic liver disease and the cardiovascular system","volume":"35","author":"Manolis","year":"2025","journal-title":"Trends Cardiovasc Med."},{"key":"2026081404470613400_hpag064-B9","article-title":"Metabolic dysfunction-associated steatotic liver disease and peripheral arterial disease: associations and treatment considerations","author":"Polyzos SA","year":"2026","journal-title":"Curr Vasc Pharmacol"},{"key":"2026081404470613400_hpag064-B10","doi-asserted-by":"crossref","first-page":"942753","DOI":"10.3389\/fcvm.2022.942753","article-title":"Hypertension is prevalent in non-alcoholic fatty liver disease and increases all-cause and cardiovascular mortality","volume":"9","author":"Ng","year":"2022","journal-title":"Front Cardiovasc Med."},{"key":"2026081404470613400_hpag064-B11","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1161\/HYPERTENSIONAHA.119.13419","article-title":"Nonalcoholic fatty liver disease: an emerging driver of hypertension","volume":"75","author":"Zhao","year":"2020","journal-title":"Hypertension."},{"key":"2026081404470613400_hpag064-B12","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/10715762.2016.1271122","article-title":"Impact of reactive oxygen species generation on Helicobacter pylori-related extragastric diseases: a hypothesis","volume":"51","author":"Kountouras","year":"2017","journal-title":"Free Radic Res."},{"key":"2026081404470613400_hpag064-B13","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S2468-1253(23)00275-3","article-title":"Hepatocellular and extrahepatic cancer risk in people with non-alcoholic fatty liver disease","volume":"9","author":"Thomas","year":"2024","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"2026081404470613400_hpag064-B14","doi-asserted-by":"crossref","first-page":"E730","DOI":"10.1152\/ajpendo.00225.2016","article-title":"Treatment of nonalcoholic fatty liver disease: role of AMPK","volume":"311","author":"Smith","year":"2016","journal-title":"Am J Physiol Endocrinol Metab."},{"key":"2026081404470613400_hpag064-B15","doi-asserted-by":"crossref","first-page":"12279","DOI":"10.1074\/jbc.REV120.011356","article-title":"From overnutrition to liver injury: AMP-activated protein kinase in nonalcoholic fatty liver diseases","volume":"295","author":"Zhao","year":"2020","journal-title":"J Biol Chem."},{"key":"2026081404470613400_hpag064-B16","doi-asserted-by":"crossref","first-page":"8061","DOI":"10.2147\/JIR.S490418","article-title":"The NRF-2\/HO-1 signaling pathway: a promising therapeutic target for metabolic dysfunction-associated steatotic liver disease","volume":"17","author":"Li","year":"2024","journal-title":"J Inflamm Res."},{"key":"2026081404470613400_hpag064-B17","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4062\/biomolther.2024.188","article-title":"New insights into AMPK, as a potential therapeutic target in metabolic dysfunction-associated steatotic liver disease and hepatic fibrosis","volume":"33","author":"An","year":"2025","journal-title":"Biomol Ther (Seoul)"},{"key":"2026081404470613400_hpag064-B18","doi-asserted-by":"crossref","DOI":"10.3390\/ijms25158046","article-title":"Protective effects of hepatocyte stress defenders, Nrf1 and Nrf2, against MASLD progression","volume":"25","author":"Akl","year":"2024","journal-title":"Int J Mol Sci."},{"key":"2026081404470613400_hpag064-B19","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3390\/cancers2020483","article-title":"Nrf2 and NF-kappaB and their concerted modulation in cancer pathogenesis and progression","volume":"2","author":"Bellezza","year":"2010","journal-title":"Cancers (Basel)"},{"key":"2026081404470613400_hpag064-B20","doi-asserted-by":"crossref","DOI":"10.3390\/cancers14174316","article-title":"Nrf2 downregulation contributes to epithelial-to-mesenchymal transition in Helicobacter pylori-infected cells","author":"Bacon","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2026081404470613400_hpag064-B21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/s41536-021-00137-z","article-title":"Inhibition of nuclear factor (erythroid-derived 2)-like 2 promotes hepatic progenitor cell activation and differentiation","volume":"6","author":"Bellanti","year":"2021","journal-title":"NPJ Regen Med."},{"key":"2026081404470613400_hpag064-B22","doi-asserted-by":"crossref","first-page":"e42108","DOI":"10.1097\/MD.0000000000042108","article-title":"Hepatic progenitor cell activation and ductular reaction in metabolic dysfunction-associated steatotic liver disease (MASLD): indicators for disease activity and the degree of fibrosis: the pilot study","volume":"104","author":"B\u00fcy\u00fck","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"2026081404470613400_hpag064-B23","doi-asserted-by":"crossref","first-page":"156458","DOI":"10.1016\/j.metabol.2025.156458","article-title":"Imeglimin ameliorates MASLD by targeting PEN2 to activate AMPK pathway","volume":"175","author":"Li","year":"2026","journal-title":"Metabolism."},{"key":"2026081404470613400_hpag064-B24","doi-asserted-by":"crossref","first-page":"1250684","DOI":"10.1126\/science.1250684","article-title":"mTOR- and HIF-1alpha-mediated aerobic glycolysis as metabolic basis for trained immunity","volume":"345","author":"Cheng","year":"2014","journal-title":"Science."},{"key":"2026081404470613400_hpag064-B25","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1161\/ATVBAHA.120.313584","article-title":"Macrophage biology in cardiovascular diseases","volume":"41","author":"Khoury","year":"2021","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"2026081404470613400_hpag064-B26","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1161\/ATVBAHA.112.300606","article-title":"Aberrant endoplasmic reticulum stress in vascular smooth muscle increases vascular contractility and blood pressure in mice deficient of AMP-activated protein kinase-alpha2 in vivo","volume":"33","author":"Liang","year":"2013","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"2026081404470613400_hpag064-B27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12876-017-0592-y","article-title":"Non alcoholic fatty liver disease and eNOS dysfunction in humans","volume":"17","author":"Persico","year":"2017","journal-title":"BMC Gastroenterol."},{"key":"2026081404470613400_hpag064-B28","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ajg.2025.01.005","article-title":"A glimpse into Helicobacter pylori involvement in hepatic encephalopathy","volume":"26","author":"Kountouras","year":"2025","journal-title":"Arab J Gastroenterol."},{"key":"2026081404470613400_hpag064-B29","doi-asserted-by":"crossref","first-page":"e13737","DOI":"10.1111\/ijcp.13737","article-title":"Update on the association between non-alcoholic fatty liver disease and Helicobacter pylori infection","volume":"75","author":"Doulberis","year":"2021","journal-title":"Int J Clin Pract."},{"key":"2026081404470613400_hpag064-B30","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1038\/labinvest.2009.90","article-title":"Helicobacter pylori promotes hepatic fibrosis in the animal model","volume":"89","author":"Goo","year":"2009","journal-title":"Lab Invest."},{"key":"2026081404470613400_hpag064-B31","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9040933","article-title":"Active Helicobacter pylori infection is independently associated with nonalcoholic steatohepatitis in morbidly obese patients","volume":"9","author":"Doulberis","year":"2020","journal-title":"J Clin Med."},{"key":"2026081404470613400_hpag064-B32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11596-025-00001-x","article-title":"Impact of Helicobacter pylori eradication on clinical and laboratory parameters in non-alcoholic fatty liver disease patients: a systematic review and meta-analysis of randomized controlled trials","volume":"45","author":"Jaber","year":"2025","journal-title":"Curr Med Sci."},{"key":"2026081404470613400_hpag064-B33","first-page":"5521239","article-title":"Relationship of Helicobacter pylori infection with nonalcoholic fatty liver disease: a meta-analysis","volume":"2023","author":"Xu","year":"2023","journal-title":"Can J Gastroenterol Hepatol."},{"key":"2026081404470613400_hpag064-B34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.it.2003.10.013","article-title":"Inflammation: the link between insulin resistance, obesity and diabetes","volume":"25","author":"Dandona","year":"2004","journal-title":"Trends Immunol."},{"key":"2026081404470613400_hpag064-B35","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/HJH.0000000000001245","article-title":"Association between MRI-derived hepatic fat fraction and blood pressure in participants without history of cardiovascular disease","volume":"35","author":"Lorbeer","year":"2017","journal-title":"J Hypertens."},{"key":"2026081404470613400_hpag064-B36","doi-asserted-by":"crossref","first-page":"e4293","DOI":"10.1097\/MD.0000000000004293","article-title":"Association of blood pressure level with nonalcoholic fatty liver disease in nonhypertensive population: normal is not the new normal","volume":"95","author":"Qian","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2026081404470613400_hpag064-B37","doi-asserted-by":"crossref","first-page":"203","DOI":"10.2147\/CEG.S135526","article-title":"Serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) predict severity of liver disease in chronic hepatitis B","volume":"10","author":"Li","year":"2017","journal-title":"Clin Exp Gastroenterol."},{"key":"2026081404470613400_hpag064-B38","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s003950170077","article-title":"Phosphorylation of cytokeratin 8 and 18 in human vascular smooth muscle cells of atherosclerotic lesions and umbilical cord vessels","volume":"96","author":"Bar","year":"2001","journal-title":"Basic Res Cardiol."},{"key":"2026081404470613400_hpag064-B39","doi-asserted-by":"crossref","first-page":"103350","DOI":"10.1016\/j.arcmed.2025.103350","article-title":"Metabolic dysfunction-associated steatohepatitis in focus: pathogenesis, non-invasive diagnostics, and future approaches","volume":"56","author":"Ismaiel","year":"2025","journal-title":"Arch Med Res."},{"key":"2026081404470613400_hpag064-B40","doi-asserted-by":"crossref","DOI":"10.3390\/ijms241310885","article-title":"Visceral obesity and cytokeratin-18 antigens as early biomarkers of liver damage","volume":"24","author":"de Alteriis","year":"2023","journal-title":"Int J Mol Sci."},{"key":"2026081404470613400_hpag064-B41","doi-asserted-by":"crossref","first-page":"3055531","DOI":"10.1155\/cdr\/3055531","article-title":"From the liver to heart in nonalcoholic fatty liver disease: single-cell and serum evidence for cytokeratin 18 in predicting cardiovascular risk","volume":"2026","author":"Xu","year":"2026","journal-title":"Cardiovasc Ther."},{"key":"2026081404470613400_hpag064-B42","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/CM9.0000000000002603","article-title":"Hepatocyte apoptosis fragment product cytokeratin-18 M30 level and non-alcoholic steatohepatitis risk diagnosis: an international registry study","volume":"136","author":"Zhang","year":"2023","journal-title":"Chin Med J (Engl)"},{"key":"2026081404470613400_hpag064-B43","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.3748\/wjg.v12.i12.1865","article-title":"Expression of cytokeratins in Helicobacter pylori-associated chronic gastritis of adult patients infected with cagA+ strains: an immunohistochemical study","volume":"12","author":"Todorovic","year":"2006","journal-title":"World J Gastroenterol."},{"key":"2026081404470613400_hpag064-B44","doi-asserted-by":"crossref","first-page":"e12756","DOI":"10.1111\/hel.12756","article-title":"Associations between Helicobacter pylori with nonalcoholic fatty liver disease and other metabolic conditions in Guatemala","volume":"25","author":"Alvarez","year":"2020","journal-title":"Helicobacter."},{"key":"2026081404470613400_hpag064-B45","doi-asserted-by":"crossref","first-page":"1076579","DOI":"10.3389\/fnut.2023.1076579","article-title":"Helicobacter pylori infection increases the risk of nonalcoholic fatty liver disease in diabetic population","volume":"10","author":"Chen","year":"2023","journal-title":"Front Nutr."},{"key":"2026081404470613400_hpag064-B46","doi-asserted-by":"crossref","first-page":"19530","DOI":"10.1038\/s41598-022-23746-0","article-title":"Helicobacter pylori infection eradication for nonalcoholic fatty liver disease: a randomized controlled trial","volume":"12","author":"Yu","year":"2022","journal-title":"Sci Rep."},{"key":"2026081404470613400_hpag064-B47","article-title":"Persistently active Helicobacter pylori infection is associated with the development of metabolic dysfunction-associated steatotic liver disease","author":"Kim","year":"2025","journal-title":"J Clin Med."},{"key":"2026081404470613400_hpag064-B48","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/j.jalz.2019.01.008","article-title":"Impact of Helicobacter pylori and\/or Helicobacter pylori-related metabolic syndrome on incidence of all-cause and Alzheimer\u2019s dementia","volume":"15","author":"Kountouras","year":"2019","journal-title":"Alzheimers Dement."},{"key":"2026081404470613400_hpag064-B49","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms9112351","article-title":"Impact of Helicobacter pylori-related metabolic syndrome parameters on arterial hypertension","author":"Kountouras","year":"2021","journal-title":"Microorganisms."},{"key":"2026081404470613400_hpag064-B50","doi-asserted-by":"crossref","DOI":"10.3390\/metabo13030418","article-title":"The impact of nutrient intake and metabolic wastes during pregnancy on offspring hypertension: challenges and future opportunities","author":"Tain","year":"2023","journal-title":"Metabolites."},{"key":"2026081404470613400_hpag064-B51","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jhep.2025.08.017","article-title":"Effect of hypertension on long-term adverse clinical outcomes and liver fibrosis progression in MASLD","volume":"84","author":"Zhou","year":"2026","journal-title":"J Hepatol."},{"key":"2026081404470613400_hpag064-B52","doi-asserted-by":"crossref","first-page":"e70511","DOI":"10.1111\/liv.70511","article-title":"Progression to decompensation of severe fibrosis compared to cirrhosis in MASLD: a systematic review and meta-analysis","volume":"46","author":"Barrett","year":"2026","journal-title":"Liver Int."},{"key":"2026081404470613400_hpag064-B53","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1002\/hep.23280","article-title":"Obesity and nonalcoholic fatty liver disease: biochemical, metabolic, and clinical implications","volume":"51","author":"Fabbrini","year":"2010","journal-title":"Hepatology."},{"key":"2026081404470613400_hpag064-B54","doi-asserted-by":"crossref","first-page":"3496","DOI":"10.1111\/bph.13705","article-title":"Perivascular adipose tissue inflammation in vascular disease","volume":"174","author":"Nosalski","year":"2017","journal-title":"Br J Pharmacol."},{"key":"2026081404470613400_hpag064-B55","doi-asserted-by":"crossref","first-page":"1801585","DOI":"10.1002\/advs.201801585","article-title":"Insights into the epidemiology, pathogenesis, and therapeutics of nonalcoholic fatty liver diseases","volume":"6","author":"Yu","year":"2019","journal-title":"Adv Sci (Weinh)"},{"key":"2026081404470613400_hpag064-B56","doi-asserted-by":"crossref","first-page":"242","DOI":"10.5507\/bp.2014.036","article-title":"The effect of Helicobacter pylori eradication on insulin resistance and HbA1c level in people with normal glucose levels: a prospective study","volume":"159","author":"Dogan","year":"2015","journal-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub."},{"key":"2026081404470613400_hpag064-B57","doi-asserted-by":"crossref","first-page":"21630","DOI":"10.1002\/jcp.28821","article-title":"Impact of different ectopic fat depots on cardiovascular and metabolic diseases","volume":"234","author":"Ferrara","year":"2019","journal-title":"J Cell Physiol."},{"key":"2026081404470613400_hpag064-B58","first-page":"389","article-title":"The emerging role of Helicobacter pylori-induced metabolic gastrointestinal dysmotility and neurodegeneration","volume":"17","author":"Kountouras","year":"2017","journal-title":"Curr Mol Med."},{"key":"2026081404470613400_hpag064-B59","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1038\/nrgastro.2016.85","article-title":"The role of the gut microbiota in NAFLD","volume":"13","author":"Leung","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"2026081404470613400_hpag064-B60","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1159\/000051918","article-title":"Helicobacter pylori infection increases mucosal permeability of the stomach and intestine","volume":"63(Suppl 1)","author":"Fukuda","year":"2001","journal-title":"Digestion."},{"key":"2026081404470613400_hpag064-B61","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1038\/s41575-018-0011-z","article-title":"The gut-liver axis and the intersection with the microbiome","volume":"15","author":"Tripathi","year":"2018","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"2026081404470613400_hpag064-B62","first-page":"99","article-title":"Potential impact of Helicobacter pylori-related human beta-defensin-1 on hepatic encephalopathy and neurodegeneration","volume":"29","author":"Kountouras","year":"2016","journal-title":"Ann Gastroenterol."},{"key":"2026081404470613400_hpag064-B63","doi-asserted-by":"crossref","first-page":"G270","DOI":"10.1152\/ajpgi.00304.2014","article-title":"Hepatic TLR4 signaling in obese NAFLD","volume":"309","author":"Sharifnia","year":"2015","journal-title":"Am J Physiol Gastrointest Liver Physiol."},{"key":"2026081404470613400_hpag064-B64","doi-asserted-by":"crossref","first-page":"e15122","DOI":"10.7717\/peerj.15122","article-title":"The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy","volume":"11","author":"Li","year":"2023","journal-title":"PeerJ."},{"key":"2026081404470613400_hpag064-B65","first-page":"1049","article-title":"Long-term high-dose proton pump inhibitor administration to Helicobacter pylori-infected Mongolian gerbils enhances neuroendocrine tumor development in the glandular stomach","volume":"12","author":"Tsukamoto","year":"2011","journal-title":"Asian Pac J Cancer Prev."},{"key":"2026081404470613400_hpag064-B66","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s43556-025-00337-9","article-title":"Neutrophil extracellular traps (NETs) in health and disease","volume":"6","author":"Shahzad","year":"2025","journal-title":"Mol Biomed."},{"key":"2026081404470613400_hpag064-B67","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5483\/BMBRep.2024-0058","article-title":"Neutrophils in MASLD and MASH","volume":"58","author":"Shrestha","year":"2025","journal-title":"BMB Rep."},{"key":"2026081404470613400_hpag064-B68","doi-asserted-by":"crossref","first-page":"1368459","DOI":"10.3389\/fnut.2024.1368459","article-title":"Neutrophil to albumin ratio: a biomarker in non-alcoholic fatty liver disease and with liver fibrosis","volume":"11","author":"Bao","year":"2024","journal-title":"Front Nutr."},{"key":"2026081404470613400_hpag064-B69","article-title":"Predictive role of neutrophil-percentage-to-albumin ratio (NPAR) in nonalcoholic fatty liver disease and advanced liver fibrosis in nondiabetic US adults: evidence from NHANES 2017-2018","author":"Liu","year":"2023","journal-title":"Nutrients."},{"key":"2026081404470613400_hpag064-B70","first-page":"0382","article-title":"Metabolic dysfunction-associated steatohepatitis detected by neutrophilic crown-like structures in morbidly obese patients: a multicenter and clinicopathological study","volume":"7","author":"Fan","year":"2024","journal-title":"Research (Wash D C)"},{"key":"2026081404470613400_hpag064-B71","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1186\/s12967-024-05506-y","article-title":"Helicobacter pylori infection exacerbates metabolic dysfunction-associated steatotic liver disease through lipid metabolic pathways: a transcriptomic study","volume":"22","author":"Chen","year":"2024","journal-title":"J Transl Med."},{"key":"2026081404470613400_hpag064-B72","article-title":"Activated immune and complement C3 are potential contributors in MASH via stimulating neutrophil extracellular traps","author":"Liu","year":"2025","journal-title":"Cells."},{"key":"2026081404470613400_hpag064-B73","doi-asserted-by":"crossref","first-page":"1701544","DOI":"10.3389\/fnut.2025.1701544","article-title":"Helicobacter pylori infection and its impact on metabolic dysfunction-associated steatotic liver disease: a mediation analysis of neutrophil-albumin ratio","volume":"12","author":"He","year":"2025","journal-title":"Front Nutr."},{"key":"2026081404470613400_hpag064-B74","doi-asserted-by":"crossref","first-page":"e0254577","DOI":"10.1371\/journal.pone.0254577","article-title":"Associations of circulating dimethylarginines with the metabolic syndrome in the Framingham Offspring study","volume":"16","author":"Yola","year":"2021","journal-title":"PLoS One."},{"key":"2026081404470613400_hpag064-B75","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.diabres.2011.11.022","article-title":"Elevated asymmetric dimethylarginine in plasma: an early marker for endothelial dysfunction in non-alcoholic fatty liver disease?","volume":"96","author":"Dogru","year":"2012","journal-title":"Diabetes Res Clin Pract."},{"key":"2026081404470613400_hpag064-B76","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s10522-017-9676-x","article-title":"Helicobacter pylori-induced premature senescence of extragastric cells may contribute to chronic skin diseases","volume":"18","author":"Lewinska","year":"2017","journal-title":"Biogerontology."},{"key":"2026081404470613400_hpag064-B77","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.jcmgh.2020.10.015","article-title":"Inflammation-associated senescence promotes Helicobacter pylori-induced atrophic gastritis","volume":"11","author":"Cai","year":"2021","journal-title":"Cell Mol Gastroenterol Hepatol."},{"key":"2026081404470613400_hpag064-B78","doi-asserted-by":"crossref","DOI":"10.3390\/ijms27021066","article-title":"The interplay between cellular senescence and lipid metabolism in the progression of metabolic dysfunction-associated steatotic liver disease (MASLD)","author":"Mastoridou","year":"2026","journal-title":"Int J Mol Sci."},{"key":"2026081404470613400_hpag064-B79","doi-asserted-by":"crossref","DOI":"10.3390\/cells11142221","article-title":"Role of hepatocyte senescence in the activation of hepatic stellate cells and liver fibrosis progression","author":"Wijayasiri","year":"2022","journal-title":"Cells."},{"key":"2026081404470613400_hpag064-B80","doi-asserted-by":"crossref","first-page":"e32785","DOI":"10.1371\/journal.pone.0032785","article-title":"Sinusoidal endothelial dysfunction precedes inflammation and fibrosis in a model of NAFLD","volume":"7","author":"Pasarin","year":"2012","journal-title":"PLoS One."},{"key":"2026081404470613400_hpag064-B81","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.jacc.2005.01.019","article-title":"Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects","volume":"45","author":"Oshima","year":"2005","journal-title":"J Am Coll Cardiol."},{"key":"2026081404470613400_hpag064-B82","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.gtc.2016.07.003","article-title":"Nonalcoholic fatty liver disease: pathophysiology and management","volume":"45","author":"Carr","year":"2016","journal-title":"Gastroenterol Clin North Am."},{"key":"2026081404470613400_hpag064-B83","first-page":"75","article-title":"Nonalcoholic fatty liver disease: epidemiology, pathogenesis, natural history, diagnosis, and current treatment options","volume":"8","author":"Banini","year":"2016","journal-title":"Clin Med Insights Ther."},{"key":"2026081404470613400_hpag064-B84","doi-asserted-by":"crossref","first-page":"e0310361","DOI":"10.1371\/journal.pone.0310361","article-title":"The interplay between Helicobacter pylori infection and rs738409 PNPLA3 in metabolic dysfunction-associated steatotic liver disease","volume":"19","author":"Maiorana","year":"2024","journal-title":"PLoS One."},{"key":"2026081404470613400_hpag064-B85","first-page":"7708","article-title":"Identification of key genes in non\u2011alcoholic fatty liver disease progression based on bioinformatics analysis","volume":"17","author":"Li","year":"2018","journal-title":"Mol Med Rep."},{"key":"2026081404470613400_hpag064-B86","doi-asserted-by":"crossref","first-page":"24155","DOI":"10.18632\/oncotarget.23816","article-title":"Clinical application of angiotensin receptor blockers in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis","volume":"9","author":"Li","year":"2018","journal-title":"Oncotarget."},{"key":"2026081404470613400_hpag064-B87","doi-asserted-by":"crossref","first-page":"1539283","DOI":"10.3389\/fmed.2025.1539283","article-title":"Impact of hypertension on liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease","volume":"12","author":"Gao","year":"2025","journal-title":"Front Med (Lausanne)"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/advance-article-pdf\/doi\/10.1093\/ajh\/hpag064\/68579337\/hpag064.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/39\/9\/1045\/68579337\/hpag064.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/39\/9\/1045\/68579337\/hpag064.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T08:56:27Z","timestamp":1786697787000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/39\/9\/1045\/8713436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":87,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,6,22]]},"published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpag064","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,6,22]]}}}