디지털융복합연구 (Journal of Digital Convergence)

  • 제12권3호
  • /
  • Pages.345-352
  • /
  • 2014
  • /
  • 2713-6434(pISSN)
  • /
  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
권호 표지
DOI QR코드

DOI QR Code

초음파로 진단된 지방간 질환과 대장 용종과의 연관성

Relationship of Colorectal Polyps and Fatty Liver Disease Diagnosed by Ultrasonography

  • 이혜남 (한서대학교 보건의료학과) ;
  • 임청환 (한서대학교 보건의료학과) ;
  • 정홍량 (한서대학교 보건의료학과)
  • 투고 : 2014.02.03
  • 심사 : 2014.03.20
  • 발행 : 2014.03.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

지방간은 초음파검사에 의해 진단되는 임상적으로 흔한 간질환이다. 본 연구에서는 지방간과 대장암의 전구병변인 대장용종과의 연관성을 분석하여 지방간에 대한 보다 포괄적인 접근방법을 제시하고자 한다. 2012년부터 2013년 1년 동안 청주소재 소화기내과전문센터에서 복부초음파와 대장내시경검사를 동시에 시행한 만성간질환이나 대장질환이 없는 성인 348명을 대상으로 하였다. 지방간과 대장용종의 Chi-Square test에서 지방간이 있는 사람이 지방간이 없는 사람보다 유의미하게 용종이 많이 발생하였다(p<.001). 각 요인별 상관관계를 보았을 때 지방간과 대장용종간의 상관관계가 가장 높았다(p<.001). 다중회귀분석에서는 지방간(OR 3.80; 95% CI 1.93.-7.50), 공복 시 혈당(OR 2.51; 95% CI 1.12-5.62), 나이(OR 2.12; 95% CI 1.27-3.54) 이 대장용종의 발생에 유의미하게 작용하였다. 이상의 연구결과에서 초음파검사로 진단된 지방간이 대장용종의 발생에 있어 유의미한 영향력을 나타내어 지방간으로 진단되었을 때에는 대장내시경검사를 좀 더 적극적으로 고려해보는 것이 좋을 것이다.

This study proposes a more comprehensive approach for FLD by analyzing the relationship of colorectal polyps, which are precursors of colorectal cancer. In Chi-Square tests of FLD and colorectal polyps, the prevalence of colorectal polyps was significantly high in cases of FLD. The polyps and correlation of each factor showed a positive relationship with all factors, and the correlation coefficient with FLD was highest (r = 0.39, p <.001). In multiple regression analysis, FLD(OR 3.80 95% CI 1.93.-7.50), FBS (OR 2.51; 95% CI 1.12-5.62), and older age (OR 2.12; 95% CI 1.27-3.54) were independent risk factors for colorectal polyps. FLD was associated with the prevalence of colorectal polyps. These results show a meaningful influenceof FLD by ultrasonography in the occurrence of colorectal polyps, and that positive consideration of colonoscopy is needed for diagnosed FLD.

키워드

참고문헌

  1. http://kostat.go.kr/portal/korea/index.action
  2. Yong Kyun Cho, Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps, kor.J Gastroenterology and Hepatology, pp. 562-567, 2010
  3. Sidney Winawer, Colorectal cancer screening and surveillance: Clinical guidelines and rationale Update based on new evidence, vol. 124, no. 2, pp. 544-560, 2003 https://doi.org/10.1053/gast.2003.50044
  4. Ann G, Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths", N Engl J Med, 366, pp.687-696, 2012 https://doi.org/10.1056/NEJMoa1100370
  5. Adachi miki, Adenoma-carcinoma sequence, Jap. Gastroenterological Surgery, vol. 28, no. 5, pp.547-552, 2005
  6. Jackman RJ, The adenoma-carcinoma sequence in cancer of the colon. Surg Gynecol Obset, 93. pp.327-330. 1951
  7. Bae TS, Clinical Significance of the Colorectal Polyps, vol. 16, no. 4, pp.247-253, 2000
  8. Oh sw. Effect of excess weight on cancer incidence depending on cancer sites and histologic finding among men: Korea National Health Insurance Coporation Study, J Clin Oncol, vol. 23. pp.4742-4754. 2005 https://doi.org/10.1200/JCO.2005.11.726
  9. Frezza EE. Influence of obesity on the risk of developing colon cancer, Chiriva Internati M,Gut, 55. pp.285-291. 2006
  10. Zhang H, Long term body weight fluctuation is associated with metabolic syndrome indepen -dent of current body mass index among Japanese men, Circ J, vol. 69, no. 1, pp.13-18, 2005 https://doi.org/10.1253/circj.69.13
  11. Jeong Hoon Ji, Clinicopathologic Study of Colorectal Polyps and Obesity in Korean Adults, Kor. J Gastroenterol, vol. 49, no. 1, pp. 10-17, 2007
  12. Chang-Sup Kim, Association of Obesity and Left Colonic Adenomatous Polyps in Korean Adult Men, J. Prev Med Public Health, vol. 38, no.4, pp.415-419, 2005
  13. Ji Hyung Nam, Clinical Characteristics and Risk Factors of Colon Polyps in Gyeongju and Pohang Area, Korean J. of Gastroenterology, vol. 52, no. 3 pp.142-149, 2008
  14. Jeong-Hoon Lee, Hepatic steatosis index: A simple screening tool reflecting nonalcoholic fatty liver disease, Digestive and Liver Disease, vol. 42, no. 7, pp.503-508, 2010 https://doi.org/10.1016/j.dld.2009.08.002
  15. Sun Hee Lee, Relation between Weight History during Adult Period and Non-alcoholic Fatty Liver Disease in Non-obese Men, J. Korean Society for the Study of Obesity, vol.18, no.2, pp.53-58, 2009
  16. Deok Yun Ju, The influence of waist circumference on insulin resistance and nonalcoholic fatty liver disease in apparently healthy Korean adults, Clinical and Molecular Hepatology, vol. 19, no. 2, pp. 140-147, 2013 https://doi.org/10.3350/cmh.2013.19.2.140
  17. Fan JG,. Epidemiology of non-alcoholic fatty liver disease in China, J Hepatol, vol. 50, no.1, pp. 204-210, 2009 https://doi.org/10.1016/j.jhep.2008.10.010
  18. Su yeon choi, Nonalcoholic fatty liver disease as a risk factor of cardiovascular disease;relation of non-alcoholic fatty liver disease to carotid atherosclerosis, Kor. J. hepatology, vol. 14, pp.77-88, 2008 https://doi.org/10.3350/kjhep.2008.14.1.77
  19. Kotronen A. Non-alcoholic and alcoholic Fatty Liver Disease two Diseases of Affluence associated with the Metabolic Syndrome and Type 2 Diabetes: the FIN-D2D Survey, BMC Public Health, 10.10.1.2010 https://doi.org/10.1186/1471-2458-10-237
  20. Cheol Soon Im, Risk Factors Associated with Metabolic Syndrome in Ultrasonographic Fatty Liver, J. Korean Society for the Study of Obesity, vol. 17, no .3, pp.124-131, 2008
  21. Won Gue Choi, Association between Nonalcoholic Fatty Liver Disease and Colorectal Adenoma in Health Screen Examines, Kor. J. Gastrointest Endosc, vol. 41, no. 4, pp.201-207, 2010
  22. Sin hyang sook, analysis study of incidence and risk factors of colon polys observed by colonoscopy in health promotion center, J Gastroenterology and Hepatology, vol. 25, no. 2, pp.352-356, 2005
  23. G. Lopez-Abente, Changes in colorectal cancer incidence and mortality trends in Spain, analas of Oncology , vol 21, no. 3, pp.76-82, 2010
  24. Yamada TF et al. fatty liver predicts impaired fasting glucose and type 2 diabetes-mell itus in Japanese undergoing a health checkup. J Gastroenterol Hepatol, vol 25, pp.352-356, 2010 https://doi.org/10.1111/j.1440-1746.2009.05998.x
  25. Jong Hoon Lee , Research Update Screening : Test for Colorectal Cancer: Colonoscopy and Fecal Immunochemical Test, Korean J. Gastroenterology, vol. 59. No. 5, pp.389-391. 2012 https://doi.org/10.4166/kjg.2012.59.5.389
  26. Jang YS, Retrospective study of 125 cases colon polyp patients who underwent colo -noscopic polypectomy, Korean J Gastrointest Endosc, vol 21. pp.608-613, 2000