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Liver fibrosis is associated with risk for colorectal adenoma in patients with nonalcoholic fatty liver disease.

ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is associated with risks for developing colorectal adenoma. This study aimed to evaluate the association between advanced fibrosis in NAFLD and the risk for colorectal adenoma.We retrospectively analyzed the data of 6332 adults who underwent abdominal ultrasound and 1st-time colonoscopy on the same day in a health screening program at a single center. We evaluated the presence of advanced fibrosis in NAFLD using various noninvasive score, which also analyzed the detection rate of colorectal adenoma according to the presence of advanced fibrosis in NAFLD.The subjects with NAFLD had a higher prevalence of colorectal adenoma. In the multivariate analysis, NAFLD was an independent risk factor for colorectal adenoma (adjusted odds ratio [OR], 1.15; 95% confidence interval [CI], 1.02-1.30), advanced adenoma (adjusted OR, 1.50; 95% CI, 1.12-2.01), and multiple adenomas (adjusted OR, 1.32; 95% CI, 1.01-1.73). When NAFLD was further stratified based on the stage of fibrosis using the noninvasive score models, the subjects with NAFLD and advanced fibrosis had a significantly higher risk for colorectal adenoma, advanced adenoma, and multiple adenomas than those with NAFLD without advanced fibrosis.NAFLD with advanced fibrosis might be risk factor for colorectal adenoma compared with NAFLD without advanced fibrosis.

SUBMITTER: Kim MC

PROVIDER: S-EPMC6380844 | biostudies-other | 2019 Feb

REPOSITORIES: biostudies-other

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Liver fibrosis is associated with risk for colorectal adenoma in patients with nonalcoholic fatty liver disease.

Kim Min Cheol MC Park Jung Gil JG Jang Byung Ik BI Lee Heon Ju HJ Lee Won Kee WK

Medicine 20190201 6

Nonalcoholic fatty liver disease (NAFLD) is associated with risks for developing colorectal adenoma. This study aimed to evaluate the association between advanced fibrosis in NAFLD and the risk for colorectal adenoma.We retrospectively analyzed the data of 6332 adults who underwent abdominal ultrasound and 1st-time colonoscopy on the same day in a health screening program at a single center. We evaluated the presence of advanced fibrosis in NAFLD using various noninvasive score, which also analy ...[more]

PMID: 30732129

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Project description:BACKGROUND & AIMS:There are few data from prospective studies on the effects of aspirin on fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). METHODS:We performed a prospective cohort study of 361 adults with biopsy-confirmed NAFLD, from 2006 through 2015, examined every 3-12 months for incident advanced fibrosis defined using serial measurements of validated indices (the Fibrosis-4, NAFLD fibrosis score, and aspartate aminotransferase to platelet ratio indices). Histologic analyses of liver biopsies collected at baseline were performed by a blinded pathologist. Information collected at baseline and at each examination included frequency and duration of aspirin and nonsteroidal anti-inflammatory drug (NSAID) use. Using multivariable-adjusted logistic regression, we estimated the association of aspirin use with prevalent steatohepatitis (NASH) and fibrosis. Using multivariable-adjusted Cox proportional hazards modeling, we estimated the association between aspirin use and risk for fibrosis progression. RESULTS:At enrollment, 151 subjects used aspirin daily. Compared with non-regular use, daily aspirin use was associated with significantly lower odds of NASH (adjusted odds ratio, 0.68; 95% CI, 0.37-0.89) and fibrosis (adjusted odds ratio, 0.54; 95% CI, 0.31-0.82). Among individuals with baseline F0-F2 fibrosis (n = 317), 86 developed advanced fibrosis over 3692 person-years. Daily aspirin users had significantly lower risk for developing incident advanced fibrosis vs non-regular users (adjusted hazard ratio [aHR], 0.63; 95% CI, 0.43-0.85). This relationship appeared to be duration dependent (adjusted P trend=.026), with the greatest benefit found with at least 4 years or more of aspirin use (aHR, 0.50; 95% CI, 0.35-0.73). Conversely, use of nonaspirin NSAIDs was not associated with risk for advanced fibrosis (aHR, 0.93; 95% CI, 0.81-1.05). CONCLUSIONS:In a prospective study of patients with biopsy-proven NAFLD, daily aspirin use was associated with less severe histologic features of NAFLD and NASH, and lower risk for progression to advanced fibrosis with time.

Project description:BackgroundThe risk of advanced fibrosis in first-degree relatives of patients with nonalcoholic fatty liver disease and cirrhosis (NAFLD-cirrhosis) is unknown and needs to be systematically quantified. We aimed to prospectively assess the risk of advanced fibrosis in first-degree relatives of probands with NAFLD-cirrhosis.MethodsThis is a cross-sectional analysis of a prospective cohort of 26 probands with NAFLD-cirrhosis and 39 first-degree relatives. The control population included 69 community-dwelling twin, sib-sib, or parent-offspring pairs (n = 138), comprising 69 individuals randomly ascertained to be without evidence of NAFLD and 69 of their first-degree relatives. The primary outcome was presence of advanced fibrosis (stage 3 or 4 fibrosis). NAFLD was assessed clinically and quantified by MRI proton density fat fraction (MRI-PDFF). Advanced fibrosis was diagnosed by liver stiffness greater than 3.63 kPa using magnetic resonance elastography (MRE).ResultsThe prevalence of advanced fibrosis in first-degree relatives of probands with NAFLD-cirrhosis was significantly higher than that in the control population (17.9% vs. 1.4%, P = 0.0032). Compared with controls, the odds of advanced fibrosis among the first-degree relatives of probands with NAFLD-cirrhosis were odds ratio 14.9 (95% CI, 1.8-126.0, P = 0.0133). Even after multivariable adjustment by age, sex, Hispanic ethnicity, BMI, and diabetes status, the risk of advanced fibrosis remained both statistically and clinically significant (multivariable-adjusted odds ratio 12.5; 95% CI, 1.1-146.1, P = 0.0438).ConclusionUsing a well-phenotyped familial cohort, we demonstrated that first-degree relatives of probands with NAFLD-cirrhosis have a 12 times higher risk of advanced fibrosis. Advanced fibrosis screening may be considered in first-degree relatives of NAFLD-cirrhosis patients.Trial registrationUcsd irb140084.FundingNational Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Environmental Health Sciences, NIH.

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Liver fibrosis is associated with risk for colorectal adenoma in patients with nonalcoholic fatty liver disease.

Publications

Liver fibrosis is associated with risk for colorectal adenoma in patients with nonalcoholic fatty liver disease.

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