Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study.

Shuhei Fukunaga,Mohammed Eslam,Akihiro Ouchi,Tsutomu Nagata,Keiichi Mitsuyama,Ryuichi Nouno,Takuji Torimura,Takumi Kawaguchi,Jacob George,Hidefumi Kuroki,Koutaro Kawaguchi,Hirohiko Abe,Hidemichi Kawata,Dan Nakano

doi:10.3390/ijms22115462

Abstract

Colorectal adenoma is linked to metabolic dysfunction. Metabolic dysfunction-associated fatty liver disease (MAFLD) has a precise definition and three subtypes, including non-obese MAFLD. We aimed to investigate the impact of MAFLD on the prevalence of colorectal adenoma by comparing it to non-alcoholic fatty liver disease (NAFLD) in health check-up examinees. This is a multicenter retrospective study. We enrolled 124 consecutive health check-up examinees who underwent colonoscopy. NAFLD and MAFLD were present in 58 and 63 examinees, respectively. Colorectal adenoma was diagnosed by biopsy. The impact of the MAFLD definition on the prevalence of colorectal adenoma was investigated by logistic regression, decision-tree, and random forest analyses. In logistic regression analysis, MAFLD was identified as the only independent factor associated with the presence of colorectal adenoma (OR 3.191; 95% CI 1.494–7.070; p = 0.003). MAFLD was also identified as the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (29 variable importance value). Among the three subtypes of MAFLD, non-obese MAFLD was the sole independent factor associated with the presence of colorectal adenoma (OR 3.351; 95% CI 1.589–7.262; p ≤ 0.001). Non-obese MAFLD was also the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (31 variable importance value). MAFLD, particularly non-obese MAFLD, is the most important factor associated with the presence of colorectal adenoma rather than NAFLD. Colonoscopy examination should be considered in patients with MAFLD, especially those who are non-obese.

Highlights

The prevalence of colorectal cancer is increasing, with over 1.8 million new colorectal cancer cases being reported each year [1]
We demonstrate that Metabolic dysfunction-associated fatty liver disease (MAFLD) is the only independent factor associated with the presence of colorectal adenoma
We show that MAFLD, but not non-alcoholic fatty liver disease (NAFLD), is the most important factor associated with the presence of colorectal adenoma in decision-tree and random forest analyses

Summary

Introduction

The prevalence of colorectal cancer is increasing, with over 1.8 million new colorectal cancer cases being reported each year [1]. Colorectal cancer ranks second in terms of mortality, and 881,000 deaths were estimated to have occurred in 2018 [1]. Most colorectal cancers develop through the adenoma-carcinoma sequence [2]. A multicenter post-polypectomy surveillance study showed that colonoscopic polypectomy significantly reduces the risk of death from colorectal cancer [3]. Treatment of colorectal adenoma is likely to be an effective strategy to reduce the risk of death from this cancer. This decision can be informed by assessing the risk factors associated with colorectal adenoma

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