NAFLD and extrahepatic cancers: have a look at the colon
Autor: | Anna Mae Diehl, Herbert Tilg |
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Rok vydání: | 2011 |
Předmět: |
Adenoma
Adult Male medicine.medical_specialty Magnetic Resonance Spectroscopy Colorectal cancer Biopsy Population Colorectal adenoma Disease Gastroenterology Article Non-alcoholic Fatty Liver Disease Internal medicine Diabetes mellitus medicine Humans education Aged education.field_of_study business.industry Liver Neoplasms Fatty liver Cancer Colonoscopy Middle Aged medicine.disease Obesity Fatty Liver Cell Transformation Neoplastic Liver Hong Kong Female Colorectal Neoplasms Epidemiologic Methods business |
Zdroj: | Gut. 60:745-746 |
ISSN: | 0017-5749 |
Popis: | Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. Design Cross-sectional study.University hospital with case recruitment from the community and clinics.Subjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy.Prevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia.NAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects.Non-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. |
Databáze: | OpenAIRE |
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