Study On The Correlation Between Nonalcoholic Fatty Liver Disease And Colorectal Adenomatous Polyps

ObjectivesTo investigate the influencing factors of colorectal adenomatous polyps.To explore the correlation between nonalcoholic fatty liver disease(NAFLD)and colorectal adenomatous polyps and the relationship between the severity of NAFLD and the risk of colorectal adenomatous polyps.MethodsA total of 112 patients with complete enteroscopy,liver transient elastic imaging(FibroTouch)and related auxiliary examination data were selected in the Department of Gastroenterology of the Second Affiliated Hospital of Kunming Medical University from March 2019 to August 2019.A total of 67 patients with colorectal adenomatous polyps were enrolled as the adenoma group,and 45 patients with normal colonoscopy or pathological examination as inflammatory and proliferative polyps were enrolled as the control group because the canceration rates of inflammatory and hyperplastic polyps rate were extremely low.The two groups were compared in terms of general data(sex,age,BMI,waist circumference,history of smoking,history of type 2 diabetes,history of hypertension,systolic blood pressure,diastolic blood pressure)and results of blood biochemical examination(cholesterol,triglycerides,HDL-C,LDL-C,alanine aminotransferase,glutamate aminotransferase,uric acid)and controlled attenuation parameters of the liver(CAP).All the subjects were divided into no fatty liver group and mild,moderate and severe NAFLD group according to FibroTouch to investigate the relationship between the severity of NAFLD and the risk of colorectal adenomatous polyps.The t-test was used for comparison of normally distributed continuous data between two groups;a one-way analysis of variance was used for comparison between multiple groups,and the least significant difference t-test was used for further comparison between two groups.The Mann-Whitney Utest was used for comparison of non-normally distributed continuous data between two groups;the Kruskal-Wallis H test was used for comparison between multiple groups,and the Nemenyi method was used for further comparison between two groups.The chi-square test was used for comparison of categorical data between groups.A logistic regression analysis was used to investigate the risk factors colorectal adenomatous polyps.Results1.Compared with the control group,the colorectal adenomatous polyps group had significantly higher levels of age mean,male incidence,BMI,waist circumference,systolic blood pressure,TC,LDL-C,ALT,CAP(P<0.05).There was no statistically significant difference in smoking history,hypertension,history of type 2 diabetes,diastolic blood pressure,UA,TG,HDL-C,AST between the two groups(P>0.05).2.Multivariate logistic regression analysis of influencing factors of colorectal adenomatous polyps,showed that age[odds ratio(OR)=1.054,95%confidence interval(95%CI):1.009～1.102]、BMI(OR=1.191,95%CI:1.026～1.382)、LDL-C(OR=2.058,95%CI:1.034～4.097)、ALT(OR=1.038,95%CI:1.008～1.070)、CAP(OR=1.320,95%CI:1.163～1.481)were independent risk factors for colorectal adenomatous polyps(P<0.05).3.A total of 78 patients with nonalcoholic fatty liver disease were enrolled in the study.Compared with the no fatty liver group,NAFLD groups had significantly higher levels of systolic blood pressure,BMI,waist circumference,UA,TG,ALT,as well as significantly lower level of HDL-C,and the differences were statistically significant(P<0.05).The heavier the nonalcoholic fatty liver disease,the higher BMI and waist circumference(P<0.05).Uric acid and triglyceride in the severe NAFLD group were higher than those in the other three groups(P<0.05).Compared with the no fatty liver group,NAFLD groups had significantly higher proportion of colorectal adenomatous polyps[severel9(73.10%)、moderate19(73.10%)、mild 14(53.80%)vs11(40.70%),x2=8.088,P=0.040].4.The logistic regression analysis to investigate the relationship between nonalcoholic fatty liver disease severity and colorectal adenomatous polyps,showed that the moderate NAFLD group[OR(95%CI)=1.044(1.007～1.083)、1.011(1.001～1.022),P<0.05],the severe NAFLD group[OR(95%CI)=1.183(1.034～1.354)、1.129(1.030～1.236),P<0.05]were risk factors for colorectal adenomatous polyps in models 1 and 2.In model 3,after adjusting for age,gender,BMI,smoking history,hypertension,type 2 diabetes,uric acid,triglyceride,LDL-C,ALT,the severe NAFLD group(OR=1.078,95%CI:1.023-1.136,P=0.005)was still the risk factor of colorectal adenomatous polyps.Conclusions1.Nonalcoholic fatty liver disease is a risk factor for colorectal adenomatous polyps.2.Patients with NAFLD is heavier,the higher the risk colorectal adenomatous polyps.3.Age,male,BMI,waist circumference,systolic pressure,TC,LDL-C,ALT,CAP are the influencing factors of colorectal adenomatous polyps.Multivariate logistic regression analysis shows that age,BMI,LDL-C,ALT,CAP are independent risk factors for colorectal adenomatous polyps.