Central Obesity Linked to Higher Risk of Colorectal Adenoma and High-Risk Adenoma in MAFLD Patients: Study

The study stated that MAFLD and central obesity are independently associated with colorectal adenoma development. MAFLD with central obesity is linked with an increased risk of colorectal adenoma and high-risk adenoma.

MAFLD, previously known as non-alcoholic fatty liver disease (NAFLD), is a burgeoning health concern globally, characterized by fat accumulation in the liver, often accompanied by obesity, insulin resistance, and other metabolic abnormalities. While its association with liver-related complications is well-established, researchers have been increasingly delving into its potential ramifications on other organs, including the colon.

Jingfang Xiong, Department of Geriatrics, Hangzhou Red Cross Hospital, Hangzhou City, Zhejiang Province, China, and colleagues aimed to analyze the risk factors associated with colorectal adenoma and to investigate the associations of MAFLD with obesity, colorectal adenoma, and high-risk adenoma.

For this purpose, the research team enrolled 1395 subjects and were divided according to the inclusion and exclusion criteria into a colorectal adenoma group (593 subjects) and a control group (802 subjects). The chi-square test was deployed to compare the characteristics of patients in the colorectal adenoma group and the control group. Univariate and multivariate logistic analyses were used to analyze independent risk factors and associations with different subtypes of MAFLD. They also compared colorectal adenoma characteristics and the proportion of patients with high-risk colorectal adenoma.

The study led to the following findings:

• High-density lipoprotein (HDL-C) was significantly lower in patients in the colorectal adenoma group than in those in the control group.
• Logistic regression analysis revealed that age, obesity status, central obesity status, hypertension status, fatty liver status, diabetes status, smoking history, waist circumference, BMI, triglyceride level, HDL-C level, fasting blood glucose level, and degree of hepatic steatosis were all independent risk factors for colorectal adenoma.
• MAFLD was associated with a significantly increased risk of colorectal adenoma in patients with central obesity.
• Obesity, central obesity, diabetes, fatty liver, and degree of hepatic steatosis were all shown to be independent risk factors for high-risk colorectal adenoma.
• A greater proportion of MAFLD patients with central obesity than those without central obesity had high-risk colorectal adenoma.

The findings showed that MAFLD is independently associated with colorectal adenoma development. Patients with MAFLD combined with central obesity have a greater risk of developing high-risk colorectal adenomas.

"MAFLD combined with central obesity can be used to screen high-risk patients with colorectal adenoma or high-risk adenomas initially and recommend targeted colonoscopy for high-risk patients, which can improve the screening efficiency of colonoscopy and optimize the allocation of medical resources," the researchers wrote.

They noted the importance of early screening for colorectal adenoma and high-risk adenomas in high-risk populations, followed by early prediction, detection, and treatment of colorectal adenomatous polyps, to reduce the incidence and mortality of CRC.

Reference:

Xiong, Jingfang, et al. "MAFLD With Central Obesity Is Associated With Increased Risk of Colorectal Adenoma and High-risk Adenoma." BMC Gastroenterology, vol. 24, no. 1, 2024, p. 138.