has reported that remodeling of the gut microbiota structure could inhibit the occurrence of gastric antral inflammation and promote gastric motility (44).In addition, current data has clarified the association of obesity with GI motility disorders, which due to the decrease of ghrelin and imbalance of gut microbiota and gut-brain axis (45), all above may be an explanation of a negative association between H. pylori seropositivity and TSH levels in obese subjects, its own gastric motility disorder exceeds that caused by high TSH, which thus weakening the risk of TSH in H. pylori infection. This evidence concerns the gene GHRL and obesity due to melanocortin 4 receptor deficiency.