Study On The Relationship Between Metabolic-associated Fatty Liver Disease With Colorectal Polyps And Small Intestinal Bacterial Overgrowth

Objective:The incidence of metabolic-associated fatty liver disease(MAFLD)and colorectal polyps is increasing year by year,seriously affecting human health.Intestinal bacteria and their metabolites act on the liver through the gut-liver axis,and play an important role in the development of MAFLD and colorectal polyps.In this study,we tested the positive rate of small intestinal bacterial overgrowth(SIBO)in the MAFLD with colorectal polyps,and analyzed the correlation between SIBO and MAFLD with colorectal polyps,providing a theoretical basis for the regulation of intestinal flora in the treatment of MAFLD with colorectal polyps.Method:From January 2020 to November 2022,According to the diagnostic criteria of MAFLD and colonoscopy results,220 patients were diagnosed with MAFLD with colorectal polyps,216 patients were diagnosed with MAFLD,215 cases of colorectal polyps patients and 91 cases of healthy examination subjects were selected as research subjects from the gastroenterology department of our hospital.All patients’ clinical data and methane hydrogen breath results were collected.Comparing the clinical data of MAFLD with colorectal polyps patients and MAFLD patients,and analyzed the risk factors affecting colorectal polyps in MAFLD patients.The association between SIBO and MAFLD with colorectal polyps was explored by comparing the differences in SIBO,H2 and CH4 positive rate between MAFLD with polyps group,MAFLD group,colorectal polyps group and the normal group.Results:1.Analysis of clinical characteristics of MAFLD with colorectal polyps: Age and H.pylori positive rate of MAFLD with polyps group were higher than MAFLD group,ALT and AST levels in MAFLD with polyps group were lower than MAFLD group(P<0.05).Binary Logistic regression analysis indicated that age,H.pylori infection were risk factors for developing colorectal polyps in MAFLD patients.2.Methane hydrogen expiration result: SIBO positive rate: The SIBO positive rate of MAFLD with polyp group was 76.8%(169/220),the MAFLD group was 72.7%(157/216),the colorectal polyps group was 82.3%(177/215)and the normal group was 57.1%(52/91).H2 positive rate: The H2 positive rate of MAFLD with polyps group was 37.7%(83/220),the MAFLD group was 37.0%(80/216),the colorectal polyps group was 40.5%(87/215)and the normal group was 17.6%(16/91).CH4 positive rate: The CH4 positive rate of MAFLD with polyp group was 32.3%(71/220),the MAFLD group 41.2%(89/216),the colorectal polyps group was 48.8%(105 / 215)and the normal group 51.6%(47/91).MAFLD with colorectal polyps group,MAFLD group and colorectal polyps group showed higher SIBO and H2 positive rates than normal group,and the difference was statistically significant(P<0.01).3.Comparison between MAFLD group and colorectal polyps group: SIBO positive rate in colorectal polyps group was higher than MAFLD group,the difference was statistically significant(P<0.05),and the median value of methane in colorectal polyps group was higher than MAFLD group at different time points,with significant differences at 0min,20 min,40min and 60min(P<0.05)..4.Comparison of MAFLD with polyps group and colorectal polyps group: SIBO positive rate in colorectal polyps group was higher than MAFLD with polyp group(82.3% VS 76.8%),but the difference was not significant.The CH4 positive rate in colorectal polyps group was significantly higher than MAFLD group(48.8% VS32.3%),and the difference was significant(P<0.001).5.Comparison between MAFLD with polyp group and MAFLD group: SIBO positive rate in MAFLD with polyp group was higher than MAFLD group(76.8% VS 72.7%),the CH4 positive rate was lower than MAFLD group(32.3% VS 41.2%),but the difference was not significant.The median hydrogen at 20 min in MAFLD with polyp group was higher than MAFLD group,and the median methane at 0min was higher than MAFLD group,The difference was statistically significant(P<0.05).Conclusions:1.Age,H.pylori infection are the predisposing factors for developing colorectal polyps in MAFLD patients.2.The patients of MAFLD,colorectal polyps,and MAFLD with colorectal polyps are prone to small development Enteric bacteria overgrow,and increased methane may be related to the occurrence of colorectal polyps,but methane was not significantly increased in MAFLD with colorectal polyps.