Objective To explore the correlation between helicobacter pylori （Hp） infection and inflammatory factors， as well as its association with the progression of liver fibrosis in patients with metabolically associated fatty liver disease （MAFLD） and type 2 diabetes mellitus （T2DM）. Methods A total of 300 patients diagnosed with MAFLD and T2DM who were admitted to the Hepatology Department of Hebei Hospital of Traditional Chinese Medicine between April 2023 and March 2024 were recruited. Based on Hp infection status， these patients were classified into an Hp-positive group and an Hp-negative group. Subsequently， the clinical data， inflammatory factors， and liver fibrosis indices of the two groups were comprehensively compared. Furthermore， the patients in the Hp-positive group were randomly assigned to an intervention group and a control group. The intervention group received standard Hp eradication therapy， whereas the control group was administered placebo therapy. Pearson correlation analysis was employed to investigate the associations among Hp infection， inflammatory factors， and liver fibrosis indices. Binary logistic regression analysis was utilized to identify the independent risk factors influencing the progression of liver fibrosis. Results In both the Hp-positive and Hp-negative groups， parameters including age， fasting blood glucose （FPG）， glycosylated hemoglobin （HbA1c）， total bilirubin （TBIL）， direct bilirubin （DBIL）， indirect bilirubin （IBIL）， tumor necrosis factor-α （TNF-α）， and interleukin-6 （IL-6）， along with C-reactive protein （CRP） and liver stiffness measurement （LSM）， were meticulously measured. Statistical analysis revealed that the differences in these parameters between the two groups were significant （P < 0.05）. Specifically， within the experimental setup， the levels of TNF-α， IL-6， CRP， and LSM in the intervention group were notably lower than those in the control group （P < 0.05）. Pearson correlation analysis was employed to explore the relationships among variables， and the results indicated a positive correlation between the Hp detection value （DPM） and the levels of TNF-α， IL-6， CRP， and LSM （P < 0.05）. Furthermore， binary logistic regression analysis was conducted to identify independent risk factors. The findings demonstrated that positive Hp infection， elevated TNF-α， elevated IL-6， and elevated CRP were independent risk factors for the progression of liver fibrosis （P < 0.05）. To evaluate the diagnostic performance， the receiver operating characteristic （ROC） curve analysis was carried out. The areas under the curve （AUC） for HP infection， TNF-α， IL-6， and CRP were 0.800， 0.786， 0.769， and 0.783， respectively. These values were significantly lower than the AUC of 0.896 obtained from the combined detection （P < 0.05）. Conclusions In MAFLD patients with T2DM， DPM is closely associated with inflammatory factors （such as TNF-α， IL-6， and CRP） and the advancement of liver fibrosis. The combined detection of these factors holds significant value in predicting the progression of liver fibrosis. It can offer a reliable foundation for the clinical assessment of the risk of liver fibrosis progression.