NASH tied to increased risk for advanced colorectal polyps

  • Cho Y & al.
  • Liver Int
  • 04.06.2019

  • von Yael Waknine
  • Clinical Essentials
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Takeaway

  • Biopsy-proven nonalcoholic steatohepatitis (NASH) is tied to an increased risk for advanced colorectal neoplasm in patients with nonalcoholic fatty liver disease (NAFLD).

Why this matters

  • Findings warrant screening for colorectal cancer in patients with NAFLD.

Study design

  • Study of 476 patients aged ≥18 years with clinically suspected NAFLD who underwent screening colonoscopy as part of a biopsy-evaluated prospective cohort.
  • Funding: Seoul Metropolitan Government, Seoul National University, Boramae Medical Center.

Key results

  • 379 patients (79.6%) had biopsy-determined NAFLD, including 194 patients with NASH; the remainder (n=97) had no evidence of NAFLD and comprised the "healthy controls" arm.
  • 11.1% had advanced colorectal neoplasm (mean number, 3.0±3.5), 21.0% had low-grade polyps (mean number, 3.1±2.2), and 67.9% showed no evidence of polyps.
  • Patients with advanced colorectal neoplasms had higher grades of steatosis (P=.004) and hepatic fibrosis (P=.044).
  • Advanced colorectal neoplasms were more common in patients with nonalcoholic fatty liver (12%; P=.003) and NASH (13%; P=.05) than healthy controls (5%).
  • In multivariate analysis adjusting for age, sex, hypertension, and diabetes, NASH (vs no NAFLD) was tied to increased risks for:
    • Colorectal polyp (OR=2.08; P=.020).
    • Advanced colorectal neoplasm (OR=2.81; P=.049).

Limitations

  • Cross-sectional design.