Increased risk of colorectal malignant neoplasm in patients with nonalcoholic fatty liver disease: a large study

Abstract

Nonalcoholic fatty liver disease (NAFLD) has been suggested to be a strong risk factor of colorectal benign adenomas and advanced neoplasms. The aim of this large cohort study was to further investigate the prevalence of colorectal malignant neoplasm (CRMN) in patients with NAFLD and determine whether association between NAFLD and CRMN exists. 2,315 community subjects (1,370 males and 945 females) who underwent a routine colonoscopy according to international colorectal cancer screening guideline were recruited. Nature of colorectal lesions determined by biopsy and NAFLD was diagnosed by ultrasound. Binary logistic regression analysis was applied to explore the related associations. Prevalence of CRMN was 29.3% (77/263) in patients with NAFLD, which was significantly higher than 18.0% (369/2,052) in the control group (P<0.05). In addition, malignant neoplasm in NAFLD group occurred more frequently at sigmoid colon than in control group (14.3 vs. 11.9%). The incidence of highly-differentiated colorectal adenocarcinoma in NAFLD group was significantly higher than control group (62.3 vs. 9.8%). Univariate analysis showed that NAFLD had strong association with CRMN (OR 2.043; 95% CI 1.512-2.761; P<0.05). After adjusting for metabolic and other confounding factors, NAFLD remained as an independent risk factor for CRMN (OR 1.868; 95% CI 1.360-2.567; P<0.05). NAFLD was an independent risk factor for CRMN. Sigmoid carcinoma and highly differentiated colorectal adenocarcinoma were more commonly found in NAFLD. (ClinicalTrials.gov number, NCT01657773, website: http://clinicaltrials.gov/ct2/show/NCT01657773?term=zheng+minghua&rank=1 ).

Nonalcoholic fatty liver disease: Diagnosis, pathogenesis, and management

“…Nonalcoholic fatty liver disease is a risk factor for a lot of conditions, such as colorectal malignant neoplasm and in-stent restenosis after bare metal stenting in native coronary arteries (75,76).…”

Non-Alcoholic Fatty Liver Disease is Associated with an Excessive Calorie intake Rather than a Distinctive Dietary Pattern

“…This is in line with the observation that the Mediterranean diet, which is rich in fibers, might not only prevent diabetes, cardiovascular disease, and obesity, but also NAFLD. [14] In view of this and the fact that low fiber intake may contribute to the elevated risk for colonic neoplasms in NAFLD patients [24,25] another independent goal of dietary counselling might be to increase fiber consumption.…”

Updates on the Molecular Genetics of Colorectal Cancer

“…These SNPs have been associated with a two-fold shorter survival and include the minor alleles at rs17544464, rs209489, and rs1442089 [60]. The ELOVL5 gene encodes a fatty acid elongase, and knockout of this gene in mouse models has been associated with hepatic steatosis [61], which is an independent risk factor for distant metastatic CRC [62].…”