Gut 60:745-746 doi:10.1136/gut.2011.239392
  • Commentary

NAFLD and extrahepatic cancers: have a look at the colon

  1. Anna Mae Diehl2
  1. 1Christian Doppler Research Laboratory for Gut Inflammation, Medical University Innsbruck, Austria
  2. 2Division of Gastroenterolog, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Herbert Tilg, Christian Doppler Research Laboratory for Gut Inflammation, Medical University Innsbruck, Innsbruck 6020, Austria; herbert.tilg{at}

A high body-mass index has been demonstrated to be associated with an increased mortality not only from cardiovascular disease but also from certain cancers.1 An impressive body of evidence further indicates that the risk of colorectal adenoma and cancer is increased in subjects with obesity and related metabolic syndrome.2 Obesity has indeed a direct and independent relationship with colorectal cancer, although the strength of the association with general obesity seems to be smaller than previously reported.3 A recent French study suggests that obesity and weight gain are associated with early colorectal carcinogenesis in women especially regarding the distal colon.4 Several other studies identified an increased risk of developing also other gastrointestinal cancers such as oesophageal adenocarcinoma in the obese population. The association between obesity and other gastrointestinal malignancies, however, has been less robust. Non-alcoholic fatty liver disease (NAFLD) has arisen as one of the most prevalent liver diseases worldwide and usually develops in obese subjects. Pathophysiological insights into this disorder have improved substantially in recent years and, in addition, various clinical associations, such as insulin resistance, diabetes and cardiovascular diseases, have been well recognised. …