Visceral obesity was found to be an independent risk factor of colorectal adenoma, and insulin resistance was associated with the presence of colorectal adenoma.

Background/AimsSerum bilirubin exerts antioxidant and cytoprotective effects. In addition, elevated serum bilirubin levels are associated with a decreased risk of metabolic and cardiovascular diseases. However, few studies have evaluated whether serum bilirubin is associated with non-alcoholic fatty liver disease (NAFLD), which is closely associated with other metabolic diseases. The aim of this study was thus to elucidate the association between serum total bilirubin levels and NAFLD.MethodsA cross-sectional study of 17,348 subjects undergoing a routine health check-up was conducted. Subjects positive for hepatitis B or hepatitis C virus, or with other hepatitis history were excluded. NAFLD was diagnosed on the basis of typical ultrasonographic findings and an alcohol consumption of less than 20 g/day.ResultsThe mean age of the subjects was 49 years and 9,076 (52.3%) were men. The prevalence of NAFLD decreased steadily as the serum bilirubin level increased in both men and women (P<0.001 for both). Multivariate regression analysis adjusted for other metabolic risk factors showed that serum bilirubin level was inversely associated with the prevalence of NAFLD [odds ratio (OR)=0.88, 95% confidence interval (CI)=0.80-0.97]. Furthermore, there was an inverse, dose-dependent association between NAFLD and serum total bilirubin levels (OR=0.83, 95% CI=0.75-0.93 in the third quartile; OR=0.80, 95% CI=0.71-0.90 in the fourth quartile vs. lowest quartile, P for trend <0.001).ConclusionsSerum bilirubin levels were found to be inversely associated with the prevalence of NAFLD independent of known metabolic risk factors. Serum bilirubin might be a protective marker for NAFLD.

Acid suppressive therapy is associated with the development of SBP in cirrhotic patients with ascites. The use of PPIs is associated with mortality after SBP independent of the severity of the underlying liver disease in our retrospective cohort study.

Although adult-to-adult living donor liver transplantation (ALDLT) has shown comparable outcomes to deceased donor liver transplantation, the outcome of patients with a high MELD score (Ͼ25) and a small-for-size graft (SFSGϽ0.8% of graft-torecipient weight ratio) is not known. For 7 years, 167 consecutive hepatitis B virus-infected recipients underwent ALDLT at our institution. Based on their MELD score without additional score for hepatocellular carcinoma (HCC), the recipients were divided into Group L (low MELD score, n ϭ 105) or Group H (high MELD score, n ϭ 62). To analyze the risk of the graft size, the patients were further stratified as follows: Group Hs (high MELD score and SFSG, n ϭ 11), Hn (high MELD score and normal size graft, n ϭ 51), Ls (low MELD score and SFSG, n ϭ 18), and Ln (low MELD score and normal size graft, n ϭ 87). The primary endpoint was one-year patient survival rate (1-YSR). The mean follow-up period was 32.6 months. The mean MELD scores were 17.1 in Group L and 32.6 in Group H. Group H had more patients with the complications of cirrhosis but less patients with HCC than Group L (p Ͻ 0.05). However, major morbidity rates and 1-YSR were similar in comparisons between Group L (46.7% and 86.7%) and H (59.7% and 83.8%) (p Ͼ 0.05). 1-YSR was similar among Group Hs (72.7%), Hn (86.3%), Ls (83.3%), and Ln (88.5%) groups (p ϭ 0.278). The multivariate analysis revealed accompanying HCC and the year of transplant were risk factors for poor 1-YSR. However, 1-YSR without HCC patients was also similar in comparisons between group L (90.2%) and H (91.7%) (p ϭ 0.847), and among Group Hs (80.0%), Hn (94.7%), Ls (72.7%), and Ln (96.7%) (p ϭ 0.072). In conclusion, high MELD score (Ͼ25) didn't predict 1-YSR in ALDLT. Improvement of the 1-YSR might be affected by center's experience as well as the selection of patients with low risk of recurrence of HCC. Liver Transpl 15:496-503, 2009.

This study suggested that artificial immunization through HBV vaccination, even in adulthood, reduces the risk of liver cancer. It might also offer a practicable means of primary prevention, especially in areas with hyperendemicity of HBV infection.