Prevalence of colonic adenomas in patients with nonalcoholic fatty liver disease

Touzin, Nadege T.; Bush, Kelvin; Williams, Christopher D.; Harrison, Stephen A.

doi:10.1177/1756283x11402118

Cited by 52 publications

(58 citation statements)

References 31 publications

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“…Moreover, a large population based study from Korea comparing the relationship between ultrasound diagnosed NAFLD and colorectal adenomas found a direct association with NAFLD and colonic adenomas [16]. Other studies from USA found similar association between biopsy-confirmed NAFLD and the prevalence of colonic adenomas [17]. Currently, patients with more than 3 colonic adenomas or any adenoma >10 mm are subject to colonoscopic screening every 3 years [18].…”

Section: Discussionmentioning

confidence: 99%

Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

Mahamid

Abu-Elhija

Yassin

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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Aim. Our study aims to determine possible association between biopsy-proven nonalcoholic steatohepatitis (NASH) and hyperplastic polyps (HP) of the colon. Methods. A retrospective cohort observational study. All subjects underwent screening colonoscopy within two years. Data were extracted from the patient charts including demographic, anthropometric measurement, vital signs, underlying diseases, medical therapy, laboratory data, results of the liver biopsy with degree of fibrosis and necroinflammatory activity, the colonoscopy report, and the pathological report of the extracted polyp. Results. A total of 223 patients were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group matched for age. 14 colonic adenomas (11% of patients) were found in the NASH group compared with 16 adenomas (16% of patients) found in the control group (P = 0.9). 28 HPs were found in the NASH group (22.7%) compared with only 8 HPs in the control group (8%) (P < 0.05). 21 from the 28 (75%) HPs diagnosed in the NASH group were observed in the high degree fibrosis patients (Fibrosis Stages 3 and 4), 6 HPs (21%) were associated with Fibrosis Stages 1 and 2, and single HP (4%) was associated with Fibrosis Stage 0. Conclusions. Our study showed an association between biopsy-proven steatohepatitis and the burden of hyperplastic polyp. The severity of hepatic fibrosis may play important role in the increased occurrence of HPs.

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Section: Discussionmentioning

confidence: 99%

Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

Mahamid

Abu-Elhija

Yassin

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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“…NAFLD was also associated with multiple colorectal adenomas (≥3) and a tendency towards proximal lesions (right-sided colonic adenomas). Whether the risk of colorectal adenoma increases with NASH compared with simple steatosis is unclear with two relatively small cross-sectional studies demonstrating conflicting results 144 145. Recently, a large cross-sectional study of 26 540 asymptomatic individuals from South Korea however, found the risk for any colorectal neoplasia and advanced colorectal neoplasia to be particularly increased in patients with NAFLD with high NFS or other non-invasive fibrosis scores 146…”

Section: Epidemiological Data Linking Nafld To Risk Of Colorectal Adementioning

confidence: 99%

Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases

Adams

Anstee

Tilg

et al. 2017

Gut

888

708

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Key physiological functions of the liver, including glucose and lipid metabolism, become disturbed in the setting of non-alcoholic fatty liver disease (NAFLD) and may be associated with a systemic inflammatory '' initiated in part by liver-secreted cytokines and molecules. Consequently, the pathophysiological effects of NAFLD extend beyond the liver with a large body of clinical evidence demonstrating NAFLD to be independently associated with both prevalent and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). The magnitude of risk of developing these extrahepatic diseases parallels the underlying severity of NAFLD, such that patients with non-alcoholic steatohepatitis (NASH) appear to be at greater risk of incident CVD, CKD and T2DM than those with simple steatosis. Other modifiers of risk may include genetic variants (eg, patatin-like phospholipase domain-containing 3 and trans-membrane 6 superfamily member 2 polymorphisms), visceral adipose tissue accumulation, dietary intake and the gut microbiome. Emerging data also suggest that NAFLD may be a risk factor for colonic neoplasia and reduced bone mineral density, especially among men. Importantly, improvement/resolution of NAFLD is associated with a reduced incidence of T2DM and improved kidney function, adding weight to causality and suggesting liver focused treatments may reduce risk of extrahepatic complications. Awareness of these associations is important for the clinicians such that CVD risk factor management, screening for T2DM and CKD are part of the routine management of patients with NAFLD.

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“…Colorectal cancer (CRC) remains as one of the commonest cancers worldwide, with a million new cases diagnosed each year [1]. In the UK, there are 35,000 new cases of colorectal cancer diagnosed each year [2].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Nonalcoholic Fatty Liver Disease and Colorectal Cancer: The Future Challenges and Outcomes of the Metabolic Syndrome

Muhidin¹,

Magan

Osman

et al. 2012

Journal of Obesity

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Nonalcoholic fatty liver disease (NAFLD) is closely related to insulin resistance, metabolic syndrome, obesity, type 2 diabetes, and dyslipidaemia. Obesity and metabolic syndrome are associated with an increased cancer risk, and recent evidence demonstrated an association between NAFLD and colorectal cancer (CRC). The mechanism of how NAFLD can be associated with increased risk of CRC is not fully understood; however, NAFLD represents a condition of profound insulin resistance and a proinflammatory state. Insulin and insulin-like growth factors may promote the development of CRC through their proliferative and antiapoptotic effects. Patients with NAFLD have reduced expression of adiponectin, an adipokine with anti-inflammatory effects. Importantly, hypoadiponectinemia is associated with an increased risk of CRC. Decreased levels of adiponectin lead to increased insulin levels due to marked insulin resistance and in turn increased insulin growth factor-1 (IGF-1). Insulin binds to IGF-1 receptors and plays an important role in cell proliferation, apoptosis, and increased production of vascular endothelial growth factor, an angiogenic factor that supports cancer growth. Further studies are needed to establish (i) the pathophysiology of NAFLD with colorectal cancer, (ii) the benefit of early screening of CRC in NAFLD patients, and (iii) the impact of treatment of NAFLD in the modulation of the risk of colorectal cancer.

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Prevalence of colonic adenomas in patients with nonalcoholic fatty liver disease

Abstract: There was no difference in the prevalence of colonic adenomas when comparing the NAFLD group who had undergone colonoscopy with a group of control patients without NAFLD who had undergone colonoscopy. However, patients with negative ultrasounds appeared to have a lower polyp burden.

Cited by 52 publications

References 31 publications

Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases

The Relationship between Nonalcoholic Fatty Liver Disease and Colorectal Cancer: The Future Challenges and Outcomes of the Metabolic Syndrome

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