The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Relationship of Non-Alcoholic Fatty Liver Disease to Colorectal Neoplasia

비알코올성 지방간질환과 대장 신생물과의 연관성

  • Lee, Jue Yong (Department of Internal Medicine, Changwon Fatima Hospital) ;
  • Kim, Ja Won (Department of Internal Medicine, Changwon Fatima Hospital)
  • Received : 2012.08.06
  • Accepted : 2012.10.08
  • Published : 2013.03.01
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Abstract

Background/Aims: Metabolic syndrome is associated with an increased risk of colorectal cancer. Non-alcoholic fatty liver disease (NAFLD) is regarded as a hepatic manifestation of metabolic syndrome. Increased echogenicity suggesting NAFLD is a frequent incidental finding on ultrasound examination. This study examined whether NAFLD is related to colorectal neoplasia. Methods: We reviewed 1,938 consecutive individuals who underwent screening colonoscopy at Changwon Fatima Hospital between Jan 2009 and Sept 2011. The individuals were divided into adenomatous polyp (Group A; n = 494) and control (Group B; n = 1,444) groups. NAFLD was diagnosed by increased echogenicity on abdominal ultrasound. Results: The prevalence of NAFLD was 171 (34.6%) in group A and 336 (23.3%) in group B. Compared with normal subjects, group A subjects were more likely to be men, older, and have a higher body mass index (BMI), blood pressure, waist circumference, fasting glucose, uric acid, triglyceride, HbA1c, Hb and $\gamma$GT levels, and a higher prevalence of NAFLD, metabolic syndrome, diabetes mellitus, and hypertension. In a multiple logistic regression analysis, older age (${\geq}$ 50 years) (OR 2.051; 95% CI 1.647-2.553), male sex (OR 2.419; 95% CI 1.837-3.184), and prevalence of NAFLD (OR 1.289; 95% CI 1.004-1.655) were associated with an increased risk of adenomatous polyps. Conclusions: NAFLD is associated with a high prevalence of colorectal neoplasia. A fatty liver on abdominal ultrasound might predict the development of colorectal adenomatous polyps and cancer.

목적: 대사증후군은 대장암의 위험을 높인다. 비알코올성 지방간질환은 대사증후군의 간내발현으로 여겨진다. 복부초음파 검사 중 비알코올성 지방간질환으로 여겨지는 소견은 우연하고 빈번하게 발견된다. 본 연구의 목적은 비알코올성 지방간질환과 대장 신생물 간에 연관성을 파악하는 데 있다. 방법: 2009년 1월부터 2011년 9월까지 창원파티마병원에서 선별 대장내시경 검사와 복부 초음파 검사를 받은 1,938명을 대상으로 하였다. 우리는 1,938명을 선종성 폴립군(n = 494)과 대조군(n = 1,444)으로 분류하였다. 지방간질환은 복부 초음파에서 에코 증가로 진단되었다. 결과: 비알코올성 지방간질환의 유병률은 선종성 폴립군에서 171명(34.6%), 대조군에서 336명(23.3%)였다. 대조군과 비교하여 선종성 폴립군에서 남자, 고연령의 경향이 있었으며 BMI, 공복 혈당, 허리둘레, 당화 혈색소, 수축기, 이완기 혈압, 전체 콜레스테롤, 중성지방, 헤모글로빈, 요산, $\gamma$GT의 항목에서 통계적으로 유의하게 높은 상태를 보였다. 대사증후군, 당뇨병, 고혈압, 비알코올성 지방간질환 또한 통계적으로 유의하게 높은 유병률을 보였다. 다변량 분석을 통해, 50세 이상, 남성, 비알코올성 지방간질환 등의 변수와 선종성 폴립의 위험과의 관련성을 관찰할 수 있었다(교차비 2.051; 95% 신뢰구간, 1.647-2.553, 교차비 2.419; 95% 신뢰구간, 1.837-3.184, 교차비 1.289; 95% 신뢰구간, 1.004-1.655). 결론: 비알코올성 지방간질환은 대장신생물의 높은 유병률과 관련이 있었다. 우연히 복부 초음파에서 발견된 지방간은 대장 선종성 폴립과 대장암 발생의 위험도를 평가하는 인자로 사용할 수 있을 것으로 기대된다.

Keywords

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