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

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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).

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Abbreviations

BP:

Blood pressure

BMI:

Body mass index

CRMN:

Colorectal malignant neoplasm

CI:

Confidence interval

Hb:

Hemoglobin

HDL:

High density lipoprotein

LDL:

Low density lipoprotein

MS:

Metabolic syndrome

NCEP-ATP III:

National cholesterol education program adult treatment panel phase III

NAFLD:

Nonalcoholic fatty liver disease

OR:

Odds ratio

STROBE:

Strengthening the reporting of observational studies in epidemiology

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Acknowledgments

This work was supported by Grants from Scientific Research Foundation of Wenzhou, Zhejiang Province, China (H20090014, Y20090269), Health Bureau of Zhejiang Province (2010KYB070), Research Foundation of Education Bureau of Zhejiang Province (Y201009942), Fresh Talent Program for Science and Technology Department of Zhejiang Province (2013R413018, 2013R413035 and 2013R413015), Research Funds for Tian Qing Liver Diseases (TQGB20120057) and Project of New Century 551 Talent Nurturing in Wenzhou.

Conflict of interest

All authors declare that they do not have anything to disclose regarding funding from industries with respect to this manuscript.

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Authors and Affiliations

  1. Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou, 325000, China

    Xian-Feng Lin, Ke-Qing Shi, Wen-Yue Liu, Ying-Wan Luo, Fa-Ling Wu, Yong-Ping Chen & Ming-Hua Zheng

  2. Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China

    Xian-Feng Lin

  3. Institute of Hepatology, Wenzhou Medical University, Wenzhou, China

    Ke-Qing Shi, Fa-Ling Wu, Yong-Ping Chen & Ming-Hua Zheng

  4. Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Jie You

  5. School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China

    Wen-Yue Liu & Ying-Wan Luo

  6. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong

    Danny Ka-Ho Wong & Man-Fung Yuen

  7. State Key Laboratory for Liver Research, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong

    Danny Ka-Ho Wong & Man-Fung Yuen

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  1. Xian-Feng Lin
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Correspondence to Ming-Hua Zheng.

Additional information

Xian-Feng Lin, Ke-Qing Shi and Wen-Yue Liu are co-first authors.

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Lin, XF., Shi, KQ., You, J. et al. Increased risk of colorectal malignant neoplasm in patients with nonalcoholic fatty liver disease: a large study. Mol Biol Rep 41, 2989–2997 (2014). https://doi.org/10.1007/s11033-014-3157-y

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