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Background: Nonalcoholic fatty liver disease is associated with cardiovascular risk factors in cross-sectional analyses. However, less is known about how changes in liver fat associate with the progression of cardiovascular risk factors. Methods:A substudy (n = 808) drawn from the Framingham Heart Study underwent serial computed tomography scans 6 years apart. We performed multivariableadjusted regression to determine the association between changes in liver fat and progression of cardiovascular risk factors.Results: Each standard deviation increase in liver fat was associated with adverse progression of systolic blood pressure, diastolic blood pressure, fasting glucose, highdensity lipoprotein and log triglycerides. After adjusting for baseline cardiovascular risk, baseline body mass index (BMI), and change in BMI, increasing liver fat was significantly associated with adverse changes in fasting glucose and triglycerides. Conclusions:In a longitudinal cohort, increasing liver fat over 6 years was associated with progression of cardiovascular risk factors, even after accounting for BMI changes. K E Y W O R D SBMI, computed tomography, diabetes, metabolic syndrome, NAFLD 1340 | BRUNNER Et al.

Quality metrics in colonoscopy are a growing area of focus given the development of and need for associated reporting and potential financial penalties. Three areas specifically have been identified as important by a multi-society task force, and the evidence behind each has been presented here. These metrics are adenoma detection rate, appropriate screening interval, and cecal intubation rate. Additional factors of interest include bowel preparation cleanliness and endoscope withdrawal time. Multifaceted interventions have been implemented to improve outcomes in colonoscopy with mixed success. Given that there are some quality metrics that have been shown to impact colorectal cancer outcomes, additional research should focus on disseminating these methods in a consistent and effective way across a myriad of practice models and patient populations.