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非酒精性脂肪性肝病患者在基线结肠镜检查阴性后结直肠腺瘤风险增加。

Patients with nonalcoholic fatty liver disease have higher risk of colorectal adenoma after negative baseline colonoscopy.

机构信息

Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Colorectal Dis. 2013 Jul;15(7):830-5. doi: 10.1111/codi.12172.

Abstract

AIM

The study aimed to determine whether nonalcoholic fatty liver disease (NAFLD) is an independent risk factor of adenoma after negative baseline colonoscopy.

METHOD

A retrospective cohort study was conducted on 1522 health-check individuals who underwent two consecutive colonoscopies at Taipei Veterans General Hospital between 2003 and 2010. Those developing an adenoma after an initial negative baseline colonoscopy (adenoma group) were compared with those in whom the second colonoscopy was negative (nonadenoma group). Anthropometric measurements, biochemical tests and the presence of NAFLD were compared between the two groups.

RESULTS

The adenoma group had a higher prevalence of NAFLD than the nonadenoma group (55.6% vs 38.8%; P < 0.05). On multivariate logistic regression analysis, NAFLD was an independent risk factor (OR = 1.45, 95% CI: 1.07-1.98) for adenoma formation after a negative baseline colonoscopy. The risk of colorectal adenoma increased when NAFLD patients had other morbidities including metabolic syndrome, hypertension or smoking (OR = 2.85, 4.03 and 4.17).

CONCLUSION

NAFLD is an independent risk factor for colorectal adenoma formation after a negative baseline colonoscopy. The risk is higher in individuals with NAFLD and other comorbidities, such as hypertension, smoking or metabolic syndrome.

摘要

目的

本研究旨在确定非酒精性脂肪性肝病(NAFLD)是否是基线阴性结肠镜检查后腺瘤的独立危险因素。

方法

对 2003 年至 2010 年间在台北荣民总医院接受两次连续结肠镜检查的 1522 名健康检查个体进行了回顾性队列研究。将首次基线阴性结肠镜检查后发生腺瘤的个体(腺瘤组)与第二次结肠镜检查阴性的个体(非腺瘤组)进行比较。比较两组之间的人体测量指标、生化检查和 NAFLD 的存在情况。

结果

腺瘤组的 NAFLD 患病率高于非腺瘤组(55.6%比 38.8%;P<0.05)。多变量逻辑回归分析显示,NAFLD 是阴性基线结肠镜检查后腺瘤形成的独立危险因素(OR=1.45,95%CI:1.07-1.98)。当 NAFLD 患者存在其他合并症,如代谢综合征、高血压或吸烟时,结直肠腺瘤的风险会增加(OR=2.85、4.03 和 4.17)。

结论

NAFLD 是阴性基线结肠镜检查后结直肠腺瘤形成的独立危险因素。在合并症如高血压、吸烟或代谢综合征的 NAFLD 患者中,风险更高。

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