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Metabolic-associated fatty liver disease and Colorectal Adenoma: A Cross-Sectional Study in a Metabolically
Shiyu Peng1, Xinyi Song2, Xiaoyan Ma3
1Department of Gastroenterology, The First Affiliated Hospital of Shihezi University,Shihezi,China.
Objective:
To investigate the association between metabolic-associated fatty liver disease (MAFLD) and colorectal adenoma (CRA), providing a theoretical basis for colorectal cancer (CRC) prevention in MAFLD patients. The relationship between MAFLD and CRA risk remains incompletely elucidated.
Methods:
A retrospective cross-sectional study was conducted at the First Affiliated Hospital of Shihezi University and Altay Prefecture People's Hospital in Xinjiang, China. Participants underwent both hepatic ultrasonography and colonoscopy. Subjects were categorized into MAFLD and non-MAFLD groups based on ultrasonographic findings. Adenomas were classified via colonoscopy and histopathology as: no adenoma, low-risk adenoma (<3 adenomas with diameter <10 mm and low-grade dysplasia), or high-risk adenoma (meeting ≥1 criterion: ≥3 adenomas, diameter ≥10 mm, high-grade dysplasia, or villous features).
Results:
The detection rates of low-risk and high-risk adenomas were 31.8% and 54.5% in the MAFLD group, compared to 28.9% and 51.6% in the non-MAFLD group, respectively. After multivariate adjustment, young MAFLD patients exhibited significantly higher odds of low-risk adenomas (adjusted β = 2.0, 95% CI: 1.2-2.9, P < 0.05) and high-risk adenomas (adjusted β = 2.7, 95% CI: 1.8-3.5, P < 0.05) compared to non-MAFLD controls. Elderly MAFLD patients also demonstrated elevated detection rates of low-risk adenomas (adjusted β = 1.5, 95% CI: 1.2-1.9, P < 0.05).
Conclusion:
MAFLD is independently associated with increased detection rates of both low-risk and high-risk colorectal adenomas across age groups in the Xinjiang populations of Shihezi and Altay. These findings position MAFLD as a potential independent risk factor for CRC screening and provide critical evidence for optimizing CRC prevention strategies in MAFLD patients.
