Association between high fatty liver index and development of colorectal cancer: a nationwide cohort study with 21,592,374 Korean
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Background/Aims: In Korea, the incidence of colorectal cancer (CRC) and nonalcoholic fatty liver disease (NAFLD) has increased due to a westernized lifestyle. This study investigated whether a high fatty liver index that reflects NAFLD correlates with CRC. Methods: Data from the National Health Insurance Corporation 2009 to 2012 were analyzed. NAFLD disease was defined as a fatty liver index > 60 in the absence of alcohol consumption of ≥ 30 g/day. Results: NAFLD was identified in 2,543,649 (11.8%) of 21,592,374 participants. CRC was identified in 19,785 (0.8%) of participants with NAFLD (fatty liver index ≥ 60) and in 80,871 (0.6%) participants without NAFLD (fatty liver index < 30). Multivariate logistic regression analysis demonstrated an independent association between NAFLD and CRC after adjusting for other confounders (hazard ratio, 1.13; odds ratio, 1.12 to 1.15). In subgroup analyses, fatty liver index ≥ 60 was associated with CRC regardless of body mass index, but the association was more prominent in persons with a normal index. NAFLD, in the absence of diabetes, hypertension, or dyslipidemia, was more highly associated with CRC than when one or more of these conditions are present. Conclusions: CRC should be considered as a possibility in patients with fatty liver index ≥ 60, even in the absence of obesity or other metabolic syndromes.
Abstract
Background/Aims: In Korea, the incidence of colorectal cancer (CRC) and nonalcoholic fatty liver disease (NAFLD) has increased due to a westernized lifestyle. This study investigated whether a high fatty liver index that reflects NAFLD correlates with CRC. Methods: Data from the National Health Insurance Corporation 2009 to 2012 were analyzed. NAFLD disease was defined as a fatty liver index > 60 in the absence of alcohol consumption of ≥ 30 g/day. Results: NAFLD was identified in 2,543,649 (11.8%) of 21,592,374 participants. CRC was identified in 19,785 (0.8%) of participants with NAFLD (fatty liver index ≥ 60) and in 80,871 (0.6%) participants without NAFLD (fatty liver index < 30). Multivariate logistic regression analysis demonstrated an independent association between NAFLD and CRC after adjusting for other confounders (hazard ratio, 1.13; odds ratio, 1.12 to 1.15). In subgroup analyses, fatty liver index ≥ 60 was associated with CRC regardless of body mass index, but the association was more prominent in persons with a normal index. NAFLD, in the absence of diabetes, hypertension, or dyslipidemia, was more highly associated with CRC than when one or more of these conditions are present. Conclusions: CRC should be considered as a possibility in patients with fatty liver index ≥ 60, even in the absence of obesity or other metabolic syndromes.
참고문헌 (34)
- Jemal A, "Global cancer statistics", CA Cancer J Clin, 61, pp.69~90 (2011)
- Haggar FA, "Colorectal cancer epidemiology : incidence, mortality, survival, and risk factors", Clin Colon Rectal Surg, 22, pp.191~197 (2009)
- 신애선, "Increasing Trend of Colorectal Cancer Incidence in Korea, 1999-2009", Cancer Research and Treatment, 44(4), pp.219~226 (2012), 대한암학회[DOI]
- Ferlay J, "Cancer incidence and mortality worldwide : sources, methods and major patterns in GLOBOCAN 2012", Int J Cancer, 136, pp.E359~E386 (2015)
- Alberti KG, "Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation;International Atherosclerosis Society; and International Association for the Study of Obesity", Circulation, 120, pp.1640~1645 (2009)
- Esposito K, "Metabolic syndrome and risk of cancer : a systematic review and meta-analysis", Diabetes Care, 35, pp.2402~2411 (2012)
- McMillan DC, "ABC of obesity. Obesity and cancer", BMJ, 333, pp.1109~1111 (2006)
- Charlton MR, "Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States", Gastroenterology, 141, pp.1249~1253 (2011)
- Yki-Jarvinen H, "Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome", Lancet Diabetes Endocrinol, 2, pp.901~910 (2014)
- Lonardo A, "Nonalcoholic fatty liver disease : a precursor of the metabolic syndrome", Dig Liver Dis, 47, pp.181~190 (2015)
- Lee YI, "Colorectal neoplasms in relation to non-alcoholic fatty liver disease in Korean women : a retrospective cohort study", J Gastroenterol Hepatol, 27, pp.91~95 (2012)
- Wong VW, "High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis", Gut, 60, pp.829~836 (2011)
- Bedogni G, "The fatty liver index : a simple and accurate predictor of hepatic steatosis in the general population", BMC Gastroenterol, 6, pp.33~ (2006)
- Kozakova M, "Fatty liver index, gamma-glutamyltransferase, and early carotid plaques", Hepatology, 55, pp.1406~1415 (2012)
- Calori G, "Fatty liver index and mortality : the Cremona study in the 15th year of follow-up", Hepatology, 54, pp.145~152 (2011)
- Lee YH, "The combination of vitamin D deficiency and mild to moderate chronic kidney disease is associated with low bone mineral density and deteriorated femoral microarchitecture : results from the KNHANES 2008-2011", J Clin Endocrinol Metab, 99, pp.3879~3888 (2014)
- 오상우, "Obesity and Metabolic Syndrome in Korea", Diabetes and Metabolism Journal, 35(6), pp.561~566 (2011), 대한당뇨병학회
- Tilg H, "NAFLD and extrahepatic cancers : have a look at the colon", Gut, 60, pp.745~746 (2011)
- Lee YH, "Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: nationwide surveys (KNHANES 2008-2011)", J Hepatol, 63, pp.486~493 (2015)
- Lee JH, "Hepatic steatosis index : a simple screening tool reflecting nonalcoholic fatty liver disease", Dig Liver Dis, 42, pp.503~508 (2010)
- Gastaldelli A, "Fatty liver is associated with insulin resistance, risk of coronary heart disease, and early atherosclerosis in a large European population", Hepatology, 49, pp.1537~1544 (2009)
- Touzin NT, "Prevalence of colonic adenomas in patients with nonalcoholic fatty liver disease", Therap Adv Gastroenterol, 4, pp.169~176 (2011)
- 정은행, "Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do, Korea", Clinical and Molecular Hepatology, 19(3), pp.266~272 (2013), 대한간학회[DOI]
- Wong VW, "Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 4, pp.1154~1161 (2006)
- Wong VW, "Genetic polymorphisms of adiponectin and tumor necrosis factor-alpha and nonalcoholic fatty liver disease in Chinese people", J Gastroenterol Hepatol, 23, pp.914~921 (2008)
- Hui JM, "Beyond insulin resistance in NASH : TNF-alpha or adiponectin", Hepatology, 40, pp.46~54 (2004)
- Yousef MH, "Fatty liver without a large “belly”: magnified review of non-alcoholic fatty liver disease in non-obese patients", World J Gastrointest Pathophysiol, 8, pp.100~107 (2017)
- Zelber-Sagi S, "Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): a population based study", J Hepatol, 47, pp.711~717 (2007)
- Basaranoglu M, "Carbohydrate intake and nonalcoholic fatty liver disease : fructose as a weapon of mass destruction", Hepatobiliary Surg Nutr, 4, pp.109~116 (2015)
- Poynter JN, "Statins and the risk of colorectal cancer", N Engl J Med, 352, pp.2184~2192 (2005)
- Zhang ZJ, "Reduced risk of colorectal cancer with metformin therapy in patients with type 2diabetes : a meta-analysis", Diabetes Care, 34, pp.2323~2328 (2011)
- Sung JJ, "An updated Asia Pacific Consensus Recommendations on colorectal cancer screening", Gut, 64, pp.121~132 (2015)
- Yang BL, "External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan", PLoS One, 10, pp.e0120443~ (2015)
- McPherson S, "Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease", Gut, 59, pp.1265~1269 (2010)