The association between nonalcoholic fatty liver disease and risk of colorectal adenoma and cancer incident and recurrence: a meta-analysis of observational studies
The association between nonalcoholic fatty liver disease and risk of colorectal adenoma and cancer incident and recurrence: a meta-analysis of observational studies
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DOI：
10.1080/17474124.2019.1580143
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发表时间：
2019-04-03
影响因子：
3.9
通讯作者：
Shi, Junping
中科院分区：
文献类型：
--
作者：
Chen, Jin;Bian, Dongxue;Shi, Junping
背景和目的：生活方式的改变在非酒精性脂肪性肝病 (NAFLD) 和结直肠腺瘤和/或癌症 (CRA/CRC) 的发展中发挥着关键作用。然而，NAFLD 与 CRA/CRC 风险之间的关联尚未经过仔细评估。方法：在这项荟萃分析中，我们评估了 21 项符合条件的研究，包括 124,206 名参与者，以确定 NAFLD 与事件和复发 CRA/CRC 风险之间的关联。结果：NAFLD 的存在与任何 CRA 事件（aOR：1.30，95% CI：1.19-1.43）和晚期 CRA/CRC（aOR：1.57，95% CI：1.21-2.04）风险增加相关。 NAFLD 的严重程度影响了这种相关性：与轻度和/或中度 NAFLD 相比，重度 NAFLD 与 CRA/CRC 事件风险增加相关（aOR：2.19，95% CI：1.33-3.60）。尽管汇总 cOR 显示 NAFLD 与 CRA/CRC 复发风险增加相关（cOR = 1.73；95% CI：1.12-2.68），但调整混杂因素后，NAFLD 与 CRA/CRC 复发风险相关性较小（aOR：1.81，95% CI：0.70-4.65）。结论：NAFLD 的存在及其严重程度与 CRA/CRC 事件风险增加相关。然而，没有足够的证据表明 NAFLD 与 CRA/CRC 复发风险增加相关。
Background & aim: Lifestyle modification plays a key role in nonalcoholic fatty liver disease (NAFLD) and colorectal adenoma and/or cancer (CRA/CRC) development. However, the association between NAFLD and the risk of CRA/CRC has not been carefully evaluated. Methods: In this meta-analysis, we assessed 21 eligible studies including 124,206 participants to determine the association between NAFLD and the risk of incident and recurrent CRA/CRC. Results: NAFLD presence was associated with an increased risk of any incident CRA (aOR: 1.30, 95% CI: 1.19-1.43) and advanced incident CRA/CRC (aOR: 1.57, 95% CI: 1.21-2.04). The severity of NAFLD affected this correlation: compared to mild and/or moderate NAFLD, severe NAFLD was associated with an increased risk of incident CRA/CRC (aOR: 2.19, 95% CI: 1.33-3.60). Although pooled cOR revealed that NAFLD was associated with an increased risk of recurrent CRA/CRC (cOR = 1.73; 95% CI: 1.12-2.68), after adjustment for confounding factors, NAFLD had less correlation with the risk of recurrent CRA/CRC (aOR: 1.81, 95% CI: 0.70-4.65). Conclusions: The presence and severity of NAFLD are associated with an increased risk of incident CRA/CRC. However, there is insufficient evidence to indicate that NAFLD is associated with an increased risk of recurrent CRA/CRC.