Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.
J Gastroenterol Hepatol. 2021 Jul;36(7):1971-1978. doi: 10.1111/jgh.15350. Epub 2020 Dec 13.
This study was designed to determine whether non-alcoholic fatty liver disease (NAFLD), with or without metabolic syndrome (MetS), is a risk factor for cancer development.
We conducted a retrospective longitudinal study at the Center for Preventive Medicine, St. Luke's International Hospital. Among all participants who underwent a health checkup between 2005 and 2019, cancer development tendencies were compared between those who were diagnosed with NAFLD and those who were not. Further evaluation was conducted among NAFLD-diagnosed participants with versus without MetS in the same manner. Those with a history of a specific liver disease, any type of cancer, or alcohol consumption in any amount at the time of the initial visit were excluded from the study.
Data were collected from 30 172 participants who underwent health checkups, among whom 4394 (14.6%) had NAFLD. Over the 14-year follow-up period, 2086 participants (6.9%) developed cancer. Participants with NAFLD had a higher incidence of digestive organ neoplasms (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.07-1.67), especially in the stomach (OR: 1.40, 95% CI: 1.02-1.94) and small intestine (OR: 2.80, 95% CI: 0.87-8.96), than did those without NAFLD. Participants with NAFLD and MetS had significantly lower rates of neoplasms in respiratory and intrathoracic organs (OR: 0.35 95% CI: 0.14-0.88) and male genital organs (OR: 0.46 95% CI: 0.24-0.87) than did individuals without NAFLD.
Non-alcoholic fatty liver disease is associated with the development of gastrointestinal malignancies, while MetS is a negative risk factor for lung and prostate cancer.
本研究旨在探讨非酒精性脂肪性肝病（NAFLD）合并或不合并代谢综合征（MetS）是否为癌症发生的危险因素。
我们在圣卢克国际医院预防医学中心进行了一项回顾性纵向研究。在 2005 年至 2019 年间接受健康检查的所有参与者中，比较了诊断为 NAFLD 的患者和未诊断为 NAFLD 的患者的癌症发展趋势。我们以同样的方式，在诊断为 NAFLD 的患者中，进一步评估了合并和不合并 MetS 的患者的情况。在初次就诊时患有特定肝脏疾病、任何类型的癌症或任何量饮酒史的患者被排除在研究之外。
我们共收集了 30172 名接受健康检查的参与者的数据，其中 4394 名（14.6%）患有 NAFLD。在 14 年的随访期间，2086 名参与者（6.9%）发生了癌症。患有 NAFLD 的参与者发生消化系统器官肿瘤的发病率更高（比值比 [OR]：1.34，95%置信区间 [CI]：1.07-1.67），尤其是胃（OR：1.40，95% CI：1.02-1.94）和小肠（OR：2.80，95% CI：0.87-8.96）。与无 NAFLD 的参与者相比，患有 NAFLD 和 MetS 的参与者发生呼吸道和胸内器官肿瘤（OR：0.35，95% CI：0.14-0.88）和男性生殖器官肿瘤（OR：0.46，95% CI：0.24-0.87）的风险显著降低。
非酒精性脂肪性肝病与胃肠道恶性肿瘤的发生有关，而 MetS 是肺癌和前列腺癌的负风险因素。
