Aims: Prior evidence demonstrates an association between non-alcoholic fatty liver disease (NAFLD) and colorectal adenomas (CRA) risk. However, information using the new definition of the disease [i.e., metabolic dysfunction-associated fatty liver disease (MAFLD)] is scarce. We aimed to assess the relationship between MAFLD and CRA risk. Methods: We conducted a cross-sectional study including patients from three university centers in Chile who underwent a colonoscopy for colorectal cancer screening and abdominal imaging study. We obtained sociodemographic and clinical data, and we performed univariate and multivariable regression analyses. Results: In total, 895 patients were included; 42% were male, the mean age was 59.9 ± 9.3 years, and 37.8% (338) had CRA. Patients harboring polyps were predominantly males (48.2% vs. 38.2%, P = 0.002), older (61.6 ± 8.7 years vs. 58.9 ± 9.5 years, P < 0.001), and exhibited a higher body weight than controls [75 (66-88) kg vs. 72 (63-82.3) kg, P = 0.002]. Fifty-six percent of patients showed hepatic steatosis in imaging studies and 54.4% met MAFLD diagnostic criteria. The adenoma detection rate was higher in the MAFLD group compared to controls (46.4% vs. 27.5%, P < 0.001). In the multivariable analysis, MAFLD was significantly associated with the presence of CRA (odds ratio = 2.32; 95%CI: 1.68-3.19, P < 0.0001). There were no statistically significant differences of histopathological characteristics of the adenomas according to the presence of MAFLD. Conclusion: The present study shows that, in Chilean Hispanic subjects, MAFLD is associated with an increased risk of CRA. This information may be useful to design specific screening colonoscopy recommendations in MAFLD patients.

No abstract

Although there is broad consensus about the benefits of proton pump inhibitors in acute upper peptic bleeding, there is still controversy over their optimal dosing. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 27 randomized trials addressing this question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded high-dose proton pump inhibitors probably result in little or no difference in re-bleeding rate or mortality. The risk/benefit and cost/benefit balance probably favor use of low-doses.

No abstract