与代谢功能障碍相关的脂肪性肝病和结直肠瘤风险:全球倾向评分匹配的回顾性队列研究
Mohammad Aldiabat1,2, Ali Osman3, Malek Ayoub3
1Department of Medicine, Washington University in St Louis, St. Louis, Missouri, USA Mohameddiabat88@gmail.com.
BMJ open
|November 12, 2025
概括
代谢功能障碍相关的脂肪性肝病 (MASLD) 和代谢相关的脂肪性肝炎 (MASH) 显著增加结直肠癌 (CRC) 和良性结直肠瘤 (BCN) 的风险. 这些肝病是独立的风险因素,强调需要更新查指南.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 代谢障碍 代谢障碍 代谢障碍
- 在瘤学瘤学.
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 和其炎症形式,代谢相关的脂肪性肝炎 (MASH) 越来越普遍.
- MASLD/MASH与结直肠癌 (CRC) 和良性结直肠瘤 (BCN) 的风险之间的关联需要进一步调查.
- 肝纤维化/肝硬化在这些关联中的潜在改变作用尚未完全理解.
研究的目的:
- 评估 MASLD,MASH 和 CRC 和 BCN 的风险之间的关联.
- 为了确定肝纤维化/肝硬化是否会改变MASH患者CRC和BCN的风险.
- 评估这些关联与代谢并发症的独立性.
主要方法:
- 一项回顾性,全球性,多中心的队列研究,利用来自电子健康记录的真实数据.
- 使用1:1的倾向分数匹配,创建可比的MASLD/MASH患者和对照群.
- 分析了45-75岁的成年人,主要结果是CRC和 BCN发病率,但不包括以前患有结直肠瘤或其他慢性肝病的人.
主要成果:
- MASLD与CRC (HR 2.71) 和 BCN (HR 2.50) 的风险增加有显著的关联.
- MASH患者的CRC风险增加了5倍 (HR 5.03) 和BCN风险增加了近2倍 (HR 1.91).
- 肝纤维化/肝硬化没有显著改变MASH患者CRC或BCN的风险.
结论:
- 证实MASLD和MASH是CRC和NBC的独立风险因素,无论代谢相关疾病如何.
- 纤维化/肝硬化存在不会显著影响MASH患者的CRC风险.
- 研究结果表明,需要重新评估MASLD/MASH患者的CRC查指南,并要求对潜在机制进行进一步研究.
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