Skip to main content

Advertisement

Log in

Risk of Colorectal Neoplasia According to Fatty Liver Severity and Presence of Gall Bladder Polyps

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Fatty liver is the hepatic manifestation of metabolic syndrome (MetS) and is a known risk factor for colorectal neoplasia (CRN). Gallbladder (GB) polyps share many common risk factors with CRN. However, studies evaluating CRN risk according to fatty liver severity and the presence of GB polyps are rare.

Aim

To investigate CRN risk according to the fatty liver severity and the presence of GB polyps.

Methods

A retrospective cross-sectional study was performed on 44,220 participants undergoing colonoscopy and abdominal ultrasonography (US) as part of a health-screening program.

Results

Of the participants, fatty liver was diagnosed as mild in 27.7 %, moderate in 5.1 %, and severe in 0.4 % and 13.4 % were diagnosed with GB polyps. Mean age of participants was 42.7 years. In adjusted models, risk of overall CRN and non-advanced CRN increased with worsening fatty liver severity (P for trend = 0.007 and 0.020, respectively). Adjusted odd ratios for overall CRN and non-advanced CRN comparing participants with mild, moderate, and severe fatty liver to participants without fatty liver were 1.13 and 1.12 for mild, 1.12 and 1.10 for moderate, and 1.56 and 1.65 for severe. The presence of GB polyps did not correlate with CRN risk after adjusting for confounders.

Conclusions

CRN risk increased with worsening fatty liver severity. However the association between GB polyp and CRN was not significant in the presence of other variables. Considering that many people undergo noninvasive abdominal US as a health screen, our study will contribute to colonoscopy screening strategies in people undergoing abdominal US.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Lengauer C, Kinzler KW, Vogelstein B. Genetic instability in colorectal cancers. Nature. 1997;386:623–627.

    Article  PubMed  CAS  Google Scholar 

  2. Markowitz SD, Bertagnolli MM. Molecular origins of cancer: molecular basis of colorectal cancer. N Engl J Med. 2009;361:2449–2460.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  3. Thiis-Evensen E, Hoff GS, Sauar J, Vatn MH. Patient tolerance of colonoscopy without sedation during screening examination for colorectal polyps. Gastrointest Endosc. 2000;52:606–610.

    Article  PubMed  CAS  Google Scholar 

  4. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–1981.

    Article  PubMed  CAS  Google Scholar 

  5. Kim ER, Kim YH. Clinical application of genetics in management of colorectal cancer. Intest Res. 2014;12:184–193.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cha JM. Colonoscopy quality is the answer for the emerging issue of interval cancer. Intest Res. 2014;12:110–116.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ahmed RL, Schmitz KH, Anderson KE, Rosamond WD, Folsom AR. The metabolic syndrome and risk of incident colorectal cancer. Cancer. 2006;107:28–36.

    Article  PubMed  Google Scholar 

  8. Limburg PJ, Anderson KE, Johnson TW, et al. Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women’s Health Study. Cancer Epidemiol Biomarkers Prev. 2005;14:133–137.

    PubMed  Google Scholar 

  9. Murphy TK, Calle EE, Rodriguez C, Kahn HS, Thun MJ. Body mass index and colon cancer mortality in a large prospective study. Am J Epidemiol. 2000;152:847–854.

    Article  PubMed  CAS  Google Scholar 

  10. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–2497.

    Article  Google Scholar 

  11. Wong VW, Wong GL, Tsang SW, et al. High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis. Gut. 2011;60:829–836.

    Article  PubMed  Google Scholar 

  12. Hwang ST, Cho YK, Park JH, et al. Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps. J Gastroenterol Hepatol. 2010;25:562–567.

    Article  PubMed  CAS  Google Scholar 

  13. Kaaks R, Toniolo P, Akhmedkhanov A, et al. Serum C-peptide, insulin-like growth factor (IGF)-I, IGF-binding proteins, and colorectal cancer risk in women. J Natl Cancer Inst. 2000;92:1592–1600.

    Article  PubMed  CAS  Google Scholar 

  14. Schoen RE, Weissfeld JL, Kuller LH, et al. Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps. Gastroenterology. 2005;129:464–475.

    Article  PubMed  Google Scholar 

  15. Lim SH, Kim DH, Park MJ, et al. Is metabolic syndrome one of the risk factors for gallbladder polyps found by ultrasonography during health screening? Gut Liver. 2007;1:138–144.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Park EJ, Lee HS, Lee SH, et al. Association between metabolic syndrome and gallbladder polyps in healthy Korean adults. J Korean Med Sci. 2013;28:876–880.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Yun KE, Chang Y, Jung HS, et al. Impact of body mass index on the risk of colorectal adenoma in a metabolically healthy population. Cancer Res. 2013;73:4020–4027.

    Article  PubMed  CAS  Google Scholar 

  18. Wen CP, David Cheng TY, Tsai SP, et al. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr. 2009;12:497–506.

    Article  PubMed  Google Scholar 

  19. Hamaguchi M, Kojima T, Itoh Y, et al. The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol. 2007;102:2708–2715.

    Article  PubMed  Google Scholar 

  20. Rumack CM, Wilson SR, Charboneau JW. Diagnostic ultrasound. London: Mosby; 1998.

    Google Scholar 

  21. Jeun JW, Cha JM, Lee JI, Joo KR, Shin HP, Lim JU. Association of gallbladder polyp with the risk of colorectal adenoma. Intest Res. 2014;12:48–52.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kim CW, Yun KE, Jung HS, et al. Sleep duration and quality in relation to non-alcoholic fatty liver disease in middle-aged workers and their spouses. J Hepatol. 2013;59:351–357.

    Article  PubMed  Google Scholar 

  23. Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.

    Article  PubMed  Google Scholar 

  24. Stadlmayr A, Aigner E, Steger B, et al. Nonalcoholic fatty liver disease: an independent risk factor for colorectal neoplasia. J Intern Med. 2011;270:41–49.

    Article  PubMed  CAS  Google Scholar 

  25. Lee YI, Lim YS, Park HS. Colorectal neoplasms in relation to non-alcoholic fatty liver disease in Korean women: a retrospective cohort study. J Gastroenterol Hepatol. 2012;27:91–95.

    Article  PubMed  CAS  Google Scholar 

  26. Lukanova A, Zeleniuch-Jacquotte A, Lundin E, et al. Prediagnostic levels of C-peptide, IGF-I, IGFBP-1, -2 and -3 and risk of endometrial cancer. Int J Cancer. 2004;108:262–268.

    Article  PubMed  CAS  Google Scholar 

  27. Hsing AW, Gao YT, Chua S Jr, Deng J, Stanczyk FZ. Insulin resistance and prostate cancer risk. J Natl Cancer Inst. 2003;95:67–71.

    Article  PubMed  CAS  Google Scholar 

  28. Tangrea JA, Albert PS, Lanza E, et al. Non-steroidal anti-inflammatory drug use is associated with reduction in recurrence of advanced and non-advanced colorectal adenomas (United States). Cancer Causes Control. 2003;14:403–411.

    Article  PubMed  Google Scholar 

  29. Kim S, Keku TO, Martin C, et al. Circulating levels of inflammatory cytokines and risk of colorectal adenomas. Cancer Res. 2008;68:323–328.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  30. Balkwill F, Charles KA, Mantovani A. Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005;7:211–217.

    Article  PubMed  CAS  Google Scholar 

  31. de Visser KE, Eichten A, Coussens LM. Paradoxical roles of the immune system during cancer development. Nat Rev Cancer. 2006;6:24–37.

    Article  PubMed  Google Scholar 

  32. Wong VW, Hui AY, Tsang SW, et al. Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2006;4:1154–1161.

    Article  PubMed  CAS  Google Scholar 

  33. Wong VW, Wong GL, Tsang SW, et al. Genetic polymorphisms of adiponectin and tumor necrosis factor-alpha and nonalcoholic fatty liver disease in Chinese people. J Gastroenterol Hepatol. 2008;23:914–921.

    Article  PubMed  CAS  Google Scholar 

  34. Kim AY, Lee YS, Kim KH, et al. Adiponectin represses colon cancer cell proliferation via AdipoR1- and -R2-mediated AMPK activation. Mol Endocrinol. 2010;24:1441–1452.

    Article  PubMed  CAS  Google Scholar 

  35. Scatarige JC, Scott WW, Donovan PJ, Siegelman SS, Sanders RC. Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation. J Ultrasound Med. 1984;3:9–14.

    PubMed  CAS  Google Scholar 

  36. Graif M, Yanuka M, Baraz M, et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease. Invest Radiol. 2000;35:319–324.

    Article  PubMed  CAS  Google Scholar 

Download references

Compliance with ethical standards

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yoon Suk Jung.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, T., Yun, K.E., Chang, Y. et al. Risk of Colorectal Neoplasia According to Fatty Liver Severity and Presence of Gall Bladder Polyps. Dig Dis Sci 61, 317–324 (2016). https://doi.org/10.1007/s10620-015-3873-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-015-3873-8

Keywords

Navigation