代谢功能障碍相关脂肪性肝病、代谢功能障碍亚型与结直肠癌风险之间的关联：一项前瞻性队列研究。

Association between metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction subtypes and risk of colorectal cancer: A prospective cohort study.

作者信息

Li Yuan, Ma Xiang-Ming, Jia Jian-Guo, Cao Li-Ying

机构信息

Department of Hepatobiliary Surgery, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China.

出版信息

Clin Res Hepatol Gastroenterol. 2025 May;49(5):102573. doi: 10.1016/j.clinre.2025.102573. Epub 2025 Mar 15.

DOI:10.1016/j.clinre.2025.102573

PMID:40097070

Abstract

BACKGROUND

To evaluate the association between a new definition of metabolic dysfunction-associated steatotic liver disease (MASLD), different metabolic dysfunction subtypes and risk of colorectal cancer(CRC).

METHODS

A total of 99,979 participants who met the criteria were included from the Kailuan Study. Participants were categorized into three groups based on fatty liver disease and metabolic status: Non-SLD with metabolic normal group(NMN), Non-SLD with metabolic abnormal group(NMA) and MASLD group. Incident of CRC were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association MASLD with the risk of CRC by calculating the hazard ratios (HR) and 95 % confidence interval (CI).

RESULTS

During a mean 13.54 ± 2.78 years of follow-up, we documented 669 CRC. Multivariate Cox regression analysis showed that compared with the NMN group, MASLD participants demonstrated an increased risk of developing CRC (HR 1.54 95 %CI 1.12-2.13). The greater the number of metabolic dysfunctions, the greater the risks of CRC (P < 0.05). The HR for CRC was 1.93 (95 % CI 1.27-2.92) in MASLD participants with 4-5 items of metabolic dysfunctions. In the subtype analysis, the HR for CRC was 1.97 (95 % CI 1.13-3.45) in lean-MASLD participants and 1.55(95 %CI 1.12-2.15) in diabetes-MASLD participants.

CONCLUSION

MASLD was associated with increased risk of CRC. Moreover, MASLD individuals who complicated by lean or diabetes have an increased risk of developing CRC.

摘要

背景

评估代谢功能障碍相关脂肪性肝病（MASLD）的新定义、不同代谢功能障碍亚型与结直肠癌（CRC）风险之间的关联。

方法

从开滦研究中纳入了99979名符合标准的参与者。根据脂肪肝疾病和代谢状态将参与者分为三组：非脂肪性肝病且代谢正常组（NMN）、非脂肪性肝病且代谢异常组（NMA）和MASLD组。通过查阅病历确认CRC的发病情况。采用Cox比例风险回归模型，通过计算风险比（HR）和95%置信区间（CI）来评估MASLD与CRC风险之间的关联。

结果

在平均13.54±2.78年的随访期间，我们记录了669例CRC。多变量Cox回归分析显示，与NMN组相比，MASLD参与者发生CRC的风险增加（HR 1.54，95%CI 1.12 - 2.13）。代谢功能障碍的数量越多，CRC的风险就越大（P < 0.05）。在有4 - 5项代谢功能障碍的MASLD参与者中，CRC的HR为1.93（95%CI 1.27 - 2.92）。在亚型分析中，瘦型MASLD参与者中CRC的HR为1.97（95%CI 1.13 - 3.45），糖尿病型MASLD参与者中为1.55（95%CI 1.12 - 2.15）。