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. 2019 May 30;6(1):e000295.
doi: 10.1136/bmjgast-2019-000295. eCollection 2019.

Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study

Masahide Hamaguchi  1 , Yoshitaka Hashimoto  1 , Akihiro Obora  2 , Takao Kojima  2 , Michiaki Fukui  1
Affiliations

Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study

Masahide Hamaguchi et al. BMJ Open Gastroenterol. .

Abstract

Background: Colorectal cancer is known to be an extrahepatic complication of non-alcoholic fatty liver disease (NAFLD). However, the interaction of NAFLD with obesity for incident colorectal cancer has not been clarified yet. Moreover, the effect of NAFLD and obesity for incident gastric cancer has not been clarified yet. Thus, we investigated whether NAFLD with or without obesity would be a risk factor for incident gastric cancer as well as colorectal cancer.

Methods: The study period was set from 2003 to 2016. NAFLD was diagnosed by abdominal ultrasonography using standardised criteria. We applied the Cox proportional hazards model to investigate the effect of NAFLD with or without obesity at baseline on incident gastric cancer as well as colorectal cancer. Age, sex, lifestyle factors including smoking states, alcohol consumption and exercise, and diabetes were used as covariates.

Results: During the study period, 27 944 individuals (16 454 men and 11 490 women) were registered in the NAfld in Gifu Area, Longitudinal Analysis study. During the mean (SD) observational period of 2357 (1458) days, incident gastric cancers were diagnosed in 48 individuals (incident rate 0.48 per 1000 person-years) and incident colorectal cancers were diagnosed in 52 individuals (incident rate 0.51 per 1000 person-years). The adjusted HR of NAFLD with obesity for incident gastric cancer was 3.58 (95% CI 1.73 to 7.38, p=0.001) and that for incident colorectal cancer was 2.96 (95% CI 1.73 to 7.38, p=0.003).

Conclusion: NAFLD with obesity was a risk factor for both incident gastric cancer and colorectal cancer in apparently healthy Japanese individuals.

Keywords: NAFLD; colorectal cancer; epidemiology; gastric cancer; obesity.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Inclusion and exclusion flow chart. NAGALA, NAfld in Gifu Area, Longitudinal Analysis.
Figure 2
Figure 2
HRs of NAFLD with or without obesity for incident gastric cancer and colorectal cancer. The vertical axis shows the cumulative hazard rate for gastric cancer and colorectal cancer, and the horizontal axis indicates the observational time in days. The blue lines represent NAFLD with obesity, the red lines indicate NAFLD without obesity, the green lines indicate non-NAFLD with obesity and the black lines indicate non-NAFLD without obesity. NAFLD, non-alcoholic fatty liver disease.
See this image and copyright information in PMC

References

    1. Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology 2003;37:1202–19. 10.1053/jhep.2003.50193 - DOI - PubMed
    1. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346:1221–31. 10.1056/NEJMra011775 - DOI - PubMed
    1. Sanna C, Rosso C, Marietti M, et al. Non-alcoholic fatty liver disease and extra-hepatic cancers. Int J Mol Sci 2016;17 10.3390/ijms17050717 - DOI - PMC - PubMed
    1. Mantovani A, Dauriz M, Byrne CD, et al. Association between nonalcoholic fatty liver disease and colorectal tumours in asymptomatic adults undergoing screening colonoscopy: a systematic review and meta-analysis. Metabolism 2018;87:1–12. 10.1016/j.metabol.2018.06.004 - DOI - PubMed
    1. Tilg H, Diehl AM. NAFLD and extrahepatic cancers: have a look at the colon. Gut 2011;60:745–6. 10.1136/gut.2011.239392 - DOI - PMC - PubMed

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