Linear relationship between the Framingham Steatosis Index (FSI) and colorectal cancer (1999-2018): A nationwide...

Colorectal cancer (CRC) poses a significant challenge to public health worldwide. Mounting evidence implicates fatty liver disease as an accelerator of CRC. This study investigated the association between the Framingham Steatosis Index (FSI), also known as the Fatty Liver Substitution Index, and CRC susceptibility. This study aims to provide a theoretical foundation for developing preventive strategies and therapeutic interventions for individuals at high risk of CRC, thereby ultimately improving treatment outcomes. This study employed 1,01,316 baseline records from the NHANES database (1999-2018). The application of stringent eligibility criteria yielded 42,732 qualified subjects: 274 individuals with CRC and 42,458 control individuals. FSI quantification was performed using standardized procedures. Following covariate adjustment, analyses were performed using multivariate logistic regression, restricted cubic spline models, and stratification approaches to ascertain the relationship between FSI scores and CRC susceptibility. Within crude models, increased FSI levels were positively associated with CRC susceptibility, maintaining this direct association after covariate adjustment. Subgroup evaluations generated uniformly consistent findings across population categories, confirming the robustness of the findings. Dose-response analyses revealed a significant linear correlation, in which an increase in FSI magnitude corresponded to a heightened CRC probability. Increasing FSI levels increase the risk of developing CRC, providing new theoretical support for the diagnosis and treatment of CRC. However, cross-sectional studies aim to establish associations, and the causal relationship between the 2 requires further research to validate and assess the feasibility of applying these findings in clinical practice.