Kim Min Cheol, Park Jung Gil, Jang Byung Ik, Lee Heon Ju, Lee Won Kee
Department of Internal Medicine, Yeungnam University College of Medicine.
Medical Research Collaboration Center in KNUH and School of Medicine, Kyungpook National University, Daegu, South Korea.
Medicine (Baltimore). 2019 Feb;98(6):e14139. doi: 10.1097/MD.0000000000014139.
Nonalcoholic fatty liver disease (NAFLD) is associated with risks for developing colorectal adenoma. This study aimed to evaluate the association between advanced fibrosis in NAFLD and the risk for colorectal adenoma.We retrospectively analyzed the data of 6332 adults who underwent abdominal ultrasound and 1st-time colonoscopy on the same day in a health screening program at a single center. We evaluated the presence of advanced fibrosis in NAFLD using various noninvasive score, which also analyzed the detection rate of colorectal adenoma according to the presence of advanced fibrosis in NAFLD.The subjects with NAFLD had a higher prevalence of colorectal adenoma. In the multivariate analysis, NAFLD was an independent risk factor for colorectal adenoma (adjusted odds ratio [OR], 1.15; 95% confidence interval [CI], 1.02-1.30), advanced adenoma (adjusted OR, 1.50; 95% CI, 1.12-2.01), and multiple adenomas (adjusted OR, 1.32; 95% CI, 1.01-1.73). When NAFLD was further stratified based on the stage of fibrosis using the noninvasive score models, the subjects with NAFLD and advanced fibrosis had a significantly higher risk for colorectal adenoma, advanced adenoma, and multiple adenomas than those with NAFLD without advanced fibrosis.NAFLD with advanced fibrosis might be risk factor for colorectal adenoma compared with NAFLD without advanced fibrosis.
非酒精性脂肪性肝病(NAFLD)与结直肠腺瘤的发生风险相关。本研究旨在评估NAFLD中的高级纤维化与结直肠腺瘤风险之间的关联。我们回顾性分析了在单一中心的健康筛查项目中于同一天接受腹部超声检查和首次结肠镜检查的6332名成年人的数据。我们使用各种非侵入性评分评估NAFLD中高级纤维化的存在情况,同时还根据NAFLD中高级纤维化的存在情况分析了结直肠腺瘤的检出率。患有NAFLD的受试者结直肠腺瘤的患病率更高。在多变量分析中,NAFLD是结直肠腺瘤(校正比值比[OR],1.15;95%置信区间[CI],1.02 - 1.30)、高级腺瘤(校正OR,1.50;95%CI,1.12 - 2.01)和多发性腺瘤(校正OR,1.32;95%CI,1.01 - 1.73)的独立危险因素。当使用非侵入性评分模型根据纤维化阶段对NAFLD进行进一步分层时,与无高级纤维化的NAFLD患者相比,患有NAFLD且有高级纤维化的受试者患结直肠腺瘤、高级腺瘤和多发性腺瘤的风险显著更高。与无高级纤维化的NAFLD相比,伴有高级纤维化的NAFLD可能是结直肠腺瘤的危险因素。