Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp.

Mahmud Mahamid,Omar Abu-Elhija,Tarik Yassin,William Nseir

doi:10.1155/2017/2054871

Abstract

Aim. Our study aims to determine possible association between biopsy-proven nonalcoholic steatohepatitis (NASH) and hyperplastic polyps (HP) of the colon. Methods. A retrospective cohort observational study. All subjects underwent screening colonoscopy within two years. Data were extracted from the patient charts including demographic, anthropometric measurement, vital signs, underlying diseases, medical therapy, laboratory data, results of the liver biopsy with degree of fibrosis and necroinflammatory activity, the colonoscopy report, and the pathological report of the extracted polyp. Results. A total of 223 patients were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group matched for age. 14 colonic adenomas (11% of patients) were found in the NASH group compared with 16 adenomas (16% of patients) found in the control group (P = 0.9). 28 HPs were found in the NASH group (22.7%) compared with only 8 HPs in the control group (8%) (P < 0.05). 21 from the 28 (75%) HPs diagnosed in the NASH group were observed in the high degree fibrosis patients (Fibrosis Stages 3 and 4), 6 HPs (21%) were associated with Fibrosis Stages 1 and 2, and single HP (4%) was associated with Fibrosis Stage 0. Conclusions. Our study showed an association between biopsy-proven steatohepatitis and the burden of hyperplastic polyp. The severity of hepatic fibrosis may play important role in the increased occurrence of HPs.

Highlights

Despite being the most common type of polyp detected in the human colon and rectum, relatively little is known about the etiology, natural history, or growth of hyperplastic polyps (HP) [1, 2].HPs are considered benign lesions that have little or no malignant potential
Fatty liver disease can present as simple hepatic steatosis that may progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC)
A total of 223 patients who underwent screening colonoscopy were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group

Summary

Introduction

Despite being the most common type of polyp detected in the human colon and rectum, relatively little is known about the etiology, natural history, or growth of hyperplastic polyps (HP) [1, 2].HPs are considered benign lesions that have little or no malignant potential. Despite being the most common type of polyp detected in the human colon and rectum, relatively little is known about the etiology, natural history, or growth of hyperplastic polyps (HP) [1, 2]. Recent studies have suggested that HP may either lie in the classic adenoma-carcinoma pathway [3, 4]. Lifestyle and dietary risk factors are the most common risk factors for development of HP according to epidemiological studies; other risk factors include alcohol consumption, cigarette smoking, obesity, metabolic syndrome, and fiber intake [5, 6]. Nonalcoholic fatty liver disease (NAFLD) is emerging condition and constituted an important public health problem across the globe. Fatty liver disease can present as simple hepatic steatosis that may progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC)

Methods

Results

Conclusion