Seo Ji-Yeon, Bae Jung-Ho, Kwak Min-Sun, Yang Jong-In, Chung Su-Jin, Yim Jeong-Yoon, Lim Seon-Hee, Chung Goh-Eun
Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 39FL., Gangnam Finance Center 737, Yeoksam-dong, Gangnam-gu, Seoul 135-984, Korea.
Biomedicines. 2021 Oct 5;9(10):1401. doi: 10.3390/biomedicines9101401.
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease associated with various metabolic disorders. Metabolic dysfunction-associated fatty liver disease (MAFLD) emphasizes metabolic dysfunction in NAFLD. Although the relationship between NAFLD and colorectal adenomas has been suggested, the effect of MAFLD on colorectal adenoma has yet to be investigated. In this study, we examined the relationship between NAFLD/MAFLD and colorectal adenoma in comparison with other metabolic factors.
Examinees who underwent colonoscopy and abdominal ultrasonography on the same day from January 2012 to December 2012 were included. NAFLD was diagnosed according to the findings of ultrasonography. The Fibrosis-4 (FIB-4) index was used as a surrogate marker for advanced hepatic fibrosis. A logistic regression model was used to analyze the risk of NAFLD/MAFLD for colorectal adenoma.
The prevalence of NAFLD and MAFLD was 37.5% and 32.8%, respectively. In the multivariate analysis, male sex, older age, diabetes, and smoking increased the risk of colorectal adenoma. NAFLD and MAFLD were the most important risk factors for colorectal adenoma only in females [adjusted odds ratio (OR) 1.43 and 95% confidence interval (CI) 1.01-2.03, and OR 1.55, 95% CI 1.09-2.20, respectively]. NAFLD and MAFLD with an advanced fibrosis index were significantly associated with an increased risk of colorectal adenoma. (NAFLD: OR 1.38, 95% CI, 1.04-1.83, = 0.027; MAFLD: OR 1.45, 95% CI, 1.13-1.96, = 0.004, respectively).
NAFLD and MAFLD were significantly associated with a higher risk of colorectal adenomas, especially in females. NAFLD and MAFLD with advanced fibrosis were associated with an increased risk of colorectal adenoma. Colonoscopic examinations may be emphasized for patients with NAFLD/MAFLD, for women, or patients with the presence of hepatic fibrosis.
非酒精性脂肪性肝病（NAFLD）是与各种代谢紊乱相关的肝病最常见病因。代谢功能障碍相关脂肪性肝病（MAFLD）强调NAFLD中的代谢功能障碍。尽管已有人提出NAFLD与结直肠腺瘤之间的关系，但MAFLD对结直肠腺瘤的影响尚待研究。在本研究中，我们将NAFLD/MAFLD与结直肠腺瘤之间的关系与其他代谢因素进行了比较。
纳入2012年1月至2012年12月在同一天接受结肠镜检查和腹部超声检查的受检者。根据超声检查结果诊断NAFLD。采用Fibrosis-4（FIB-4）指数作为晚期肝纤维化的替代标志物。使用逻辑回归模型分析NAFLD/MAFLD发生结直肠腺瘤的风险。
NAFLD和MAFLD的患病率分别为37.5%和32.8%。在多变量分析中，男性、年龄较大、糖尿病和吸烟会增加患结直肠腺瘤的风险。仅在女性中，NAFLD和MAFLD是结直肠腺瘤最重要的危险因素[校正比值比（OR）分别为1.43，95%置信区间（CI）为1.01 - 2.03，以及OR 1.55，95%CI为1.09 - 2.20]。具有晚期纤维化指数的NAFLD和MAFLD与结直肠腺瘤风险增加显著相关。（NAFLD：OR 1.38，95%CI为1.04 - 1.83，P = 0.027；MAFLD：OR 1.45，95%CI为1.13 - 1.96，P = 0.004）。
NAFLD和MAFLD与结直肠腺瘤的较高风险显著相关，尤其是在女性中。伴有晚期纤维化的NAFLD和MAFLD与结直肠腺瘤风险增加相关。对于患有NAFLD/MAFLD的患者、女性或存在肝纤维化的患者，可能应强调进行结肠镜检查。
