代谢相关脂肪性肝病及其严重程度与结直肠癌的相关性
The relationship between severity of metabolic associated fatty liver disease and colorectal cancer
李雅欣 1李明 1谭诗云1
作者信息
- 1. 武汉大学人民医院消化内科,湖北 武汉 430060
- 折叠
摘要
目的 探讨代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)及其严重程度和肝纤维化程度与结直肠癌(colorectal cancer,CRC)的关系.方法 选取美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库中 2017-2018 年同时具有肝脏超声瞬时弹性成像结果和"是否患有CRC"调查问卷(MCQ-230)结果的4365 例20 岁以上的成年人作为研究对象,根据是否患CRC将研究对象分为CRC组和非CRC组(对照组).比较CRC组与对照组一般资料及MAFLD患者数目之间的差异,将研究对象根据肝脏超声瞬时弹性成像结果及FIB-4无创肝纤维化评分进行肝脂肪变性严重程度和肝纤维化程度分层,分为无/轻度脂肪肝组和中重度脂肪肝组,非进展期肝纤维化组和进展期肝纤维化组,采用Logistic回归分析MAFLD及其严重程度和肝纤维化程度与CRC的相关性.结果 年龄、BMI、腰围、高血压史、糖尿病史、代谢综合征(metabolic syndrome,MetS)、MAFLD、TG、CRP、HbA1c、CAP、肝脏硬度值(E值)、FIB-4是CRC的危险因素(P<0.05),MAFLD是CRC的独立危险因素(OR=2.510,95%CI:1.045～6.032,P=0.040),在对肝脂肪变性严重程度和肝纤维化程度进一步分层后,中重度脂肪肝与FIB-4提示的进展期肝纤维化是CRC的独立危险因素(P<0.05),然而,肝脏超声瞬时弹性成像提示的进展期肝纤维化与CRC的风险差异无统计学意义(P>0.05).结论 MAFLD及其严重程度和肝纤维化程度与CRC密切相关,且MAFLD及其严重程度和FIB-4提示的肝纤维化程度是CRC发生的独立危险因素.
Abstract
Objective To investigate the relationship between metabolic associated fatty liver disease(MAFLD)and its severity and degree of liver fibrosis and colorectal cancer(CRC).Methods A total of 4365 adults over the age of 20 years from the National Health and Nutrition Examination Survey(NHANES)database who had both liver instantane-ous elastography and CRC status questionnaire(MCQ-230)results from 2017 to 2018 were selected.The subjects were divided into CRC group and non-CRC group(control group)according to whether they had CRC or not.The differences in the general data and the number of MAFLD patients between CRC group and control group were compared.The sub-jects were divided into no/mild fatty liver group and moderate/severe fatty liver group,non-advanced and advanced he-patic fibrosis group according to the results of the liver ultrasound transient elastography and FIB-4 noninvasive liver fi-brosis score.Logistic regression analysis was used to investigate the correlation between CRC and MAFLD and its severi-ty and degree of liver fibrosis.Results Age,BMI,waist circumference,hypertension,diabetes,metabolic syndrome(MetS),MAFLD,TG,CRP,HbA1c,CAP,liver stiffness(E),FIB-4 were risk factors for CRC(P<0.05).MAFLD was an independent risk factor for CRC(OR=2.510,95%CI:1.045-6.032,P=0.040),moderate and severe fatty liver and FIB-4 suggested advanced liver fibrosis were independent risk factors for CRC after further stratification of liver steatosis severity and liver fibrosis severity(P<0.05).However,there was no statistically significant difference between the risk of advanced liver fibrosis and CRC suggested by liver ultrasound transient elastography(P>0.05).Conclusion MAFLD and its severity and degree of liver fibrosis are closely related to CRC,MAFLD and its severity and degree of liver fibrosis suggested by FIB-4 are independent risk factors for CRC.
关键词
代谢相关脂肪性肝病/FibroScan检测/无创肝纤维化评分/结直肠癌Key words
Metabolic associated fatty liver disease/FibroScan/Noninvasive liver fibrosis score/Colorectal cancer引用本文复制引用
基金项目
湖北省自然科学基金面上项目(2019CFB142)
出版年
2024
NETL
NSTL
万方数据