Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study
Abstract
:1. Introduction
2. Results
2.1. Patients’ Characteristics
2.2. Logistic Regression Analysis for Colorectal Adenoma
2.3. Decision-Tree Analysis for Colorectal Adenoma
2.4. Random Forest Analysis for Colorectal Adenoma
2.5. Patients’ Characteristics among Subtypes of MALFD
2.6. Logistic Regression Analysis for Colorectal Adenoma Using Subtypes of MALFD
2.7. Decision-Tree Analysis for Colorectal Adenoma Using Subtypes of MALFD
2.8. Random Forest Analysis for Colorectal Adenoma
3. Discussion
4. Materials and Methods
4.1. Study Design and Ethics
4.2. Study Population and Selection of Patients for Analysis
4.3. Data Collection
4.4. Biochemical Analysis
4.5. Diagnosis of Fatty Liver and Assessment for the Severity of Steatosis and Hepatic Fibrosis
4.6. Diagnosis of NAFLD
4.7. Diagnosis of MAFLD
4.8. Colonoscopy Examination and Diagnosis of Colorectal Adenoma
4.9. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All Subjects | NAFLD | MAFLD | p | ||||
---|---|---|---|---|---|---|---|
Median (IQR) | Range (min–max) | Median (IQR) | Range (min–max) | Median (IQR) | Range (min–max) | ||
Number | 124 | N/A | 46.8% (58/124) | N/A | 50.8% (63/124) | N/A | N/A |
Age (years) | 59 (50–65) | 32–88 | 58 (48–65) | 32–80 | 61 (50–65) | 32–80 | 0.5178 |
Sex (female/male) | 19.4%/80.6% (24/100) | N/A | 17.2%/82.8% (10/48) | N/A | 17.5%/82.5% (11/52) | N/A | 0.9747 |
Body mass index(kg/m2) | 23.1 (21.0–25.7) | 16.9–33.2 | 24.5 (21.8–26.5) | 16.9–33.2 | 25.0 (23.0–26.8) | 18.6–33.2 | 0.3026 |
Obesity (Yes/No) | 52.4%/47.6% (65/59) | N/A | 67.2%/32.8% (39/19) | N/A | 76.2%/23.8% (48/15) | N/A | 0.2739 |
Daily alcoholic intake (men ≥30 gms, women ≥20 gms) (Yes/No) | 15.3%/84.7% (19/105) | N/A | 0%/100% (0/58) | N/A | 20.6%/79.4% (13/50) | N/A | 0.0003 |
Ever-smoker | 27.4% (34/124) | N/A | 25.9% (15/58) | N/A | 27.0% (17/63) | N/A | 0.8888 |
Central obesity (Yes/No) | 37.1%/62.9% (46/78) | N/A | 50.0%/50.0% (29/29) | N/A | 57.1%/42.9% (36/27) | N/A | 0.4312 |
Systolic blood pressure (mmHg) | 123 (115–132) | 88–170 | 126 (117–136) | 88–170 | 127 (118–137) | 88–170 | 0.6123 |
Type 2 diabetes mellitus (Presence/Absence) | 17.7%/82.3% (22/102) | N/A | 13.8%/86.2% (8/50) | N/A | 20.6%/79.4% (13/50) | N/A | 0.3208 |
Hypertension (Presence/Absence) | 25.0%/75.0% (31/93) | N/A | 25.9%/74.1% (15/43) | N/A | 33.3%/66.7% (21/42) | N/A | 0.3691 |
Dyslipidemia (Presence/Absence) | 17.7%/82.3% (22/102) | N/A | 19.0%/81.0% (11/47) | N/A | 23.8%/76.2% (15/48) | N/A | 0.5169 |
Colorectal cancer in first-degree relatives | 3.2% (4/120) | N/A | 3.6% (2/58) | N/A | 4.8% (3/63) | N/A | 0.7168 |
Fatty liver | 58.1% (72/124) | N/A | 100% (58/58) | N/A | 100% (63/63) | N/A | N/A |
Fatty liver index (≤60/>60) | 81%/19% (101/23) | N/A | 74%/26% (43/15) | N/A | 65%/35% (41/22) | N/A | 0.3895 |
NAFLD fibrosis score (F0-F2/indeterminant score/ F3-F4) | 66%/32%/2% (82/40/2) | N/A | 72%/28%/0% (42/16/0) | N/A | 71%/27%/2% (45/17/1) | N/A | 0.6285 |
FIB-4 index | 1.24 (0.97–1.72) | 0.20– 3.67 | 0.98 (0.71–1.34) | 0.30–3.79 | 0.99 (0.74–1.37) | 0.30–3.79 | 0.5602 |
Platelet count (×104/µL) | 22 (19–25) | 10–85 | 23 (20–27) | 15–85 | 24 (20–27) | 12–85 | 0.9200 |
AST (U/L) | 23 (19–27) | 14–171 | 23 (20–26) | 15–77 | 23 (20–26) | 15–77 | 0.8467 |
ALT (U/L) | 22 (16–30) | 9–366 | 23 (18–31) | 9–107 | 23 (18–32) | 11–107 | 0.6771 |
Lactate dehydrogenase (U/L) | 167 (151–189) | 119–268 | 165 (147–190) | 126–238 | 162 (147–189) | 132–238 | 0.9966 |
ALP (U/L) | 214 (175–260) | 117–422 | 211 (175–270) | 119–422 | 213 (182–265) | 132–422 | 0.9820 |
GGT (U/L) | 25 (19–51) | 11–281 | 28 (21–52) | 12–223 | 35 (22–64) | 12–281 | 0.2765 |
Albumin (g/dL) | 4.4 (4.2–4.6) | 3.4–5.1 | 4.5 (4.2–4.6) | 3.9–5.1 | 4.5 (4.2–4.7) | 3.4–5.1 | 0.6689 |
Total bilirubin (mg/dL) | 0.8 (0.6–1.0) | 0.3–2.0 | 0.9 (0.6–1.0) | 0.3–2 | 0.9 (0.7–1.0) | 0.3–2.0 | 0.9380 |
HDL cholesterol (mg/dL) | 59 (47–70) | 28–209 | 56 (45–73) | 33–99 | 56 (45–70) | 33–93 | 0.7070 |
Triglycerides (mg/dL) | 101 (72–150) | 31–760 | 137 (89–167) | 31–440 | 142 (89–199) | 31–760 | 0.3523 |
Fasting glucose (mg/dL) | 101 (94–107) | 67–230 | 101 (95–111) | 83–230 | 103 (96–129) | 67–230 | 0.7853 |
HbA1c (%) | 5.5 (5.4–5.9) | 5.0–8.8 | 5.6 (5.4–5.9) | 5.0–8.8 | 5.6 (5.4–6.0) | 5.0–8.8 | 0.7161 |
CRP (mg/dL) | 0.07 (0.04–0.13) | 0.03– 0.31 | 0.09 (0.05–0.13) | 0.01–0.31 | 0.09 (0.06–0.13) | 0.01–0.31 | 0.7737 |
Colorectal adenomas (Presence/Absence) | 37.9%/62.1% (47/77) | N/A | 50.0%/50.0% (29/29) | N/A | 50.8/49.2 (32/31) | N/A | 0.9305 |
Obese-MAFLD | Non-Obese MAFLD | T2DM-MAFLD | p | ||||
---|---|---|---|---|---|---|---|
Median (IQR) | Range (min–max) | Median (IQR) | Range (min–max) | Median (IQR) | Range (min–max) | ||
Number | 38.7% (48/124) | N/A | 43.5% (54/124) | N/A | 10.5% (13/124) | N/A | N/A |
Age (years) | 60 (50–65) | 32–80 | 62 (51–65) | 41–80 | 65 (60–71) | 43–73 | 0.2253 |
Sex (female/male) | 14.6%/85.4% (7/41) | N/A | 18.5%/81.5% (10/44) | N/A | 23.1%/76.9% (3/10) | N/A | 0.7394 |
Body mass index (kg/m2) | 26.0 (24.8–27.0) | 23.0–33.2 | 25.2 (22.6–27) | 18.6–33.2 | 25.2 (23.7–26.5) | 20.0–33.2 | 0.1800 |
Daily alcoholic intake (men ≥30 gms, women ≥20 gms) (Yes/No) | 16.7%/83.3% (8/40) | N/A | 18.5%/81.5% (10/44) | N/A | 30.8%/69.2% (4/9) | N/A | 0.5118 |
Ever-smoker | 25.0% (12/48) | N/A | 27.8% (15/54) | N/A | 23.1% (3/13) | N/A | 0.9183 |
Central obesity (Yes/No) | 66.7%/33.3% (32/16) | N/A | 64.8%/35.2% (35/19) | N/A | 53.9%/46.2% (7/6) | N/A | 0.6898 |
Systolic blood pressure (mmHg) | 127 (117–141) | 88–170 | 130 (120–140) | 103–170 | 129 (117–141) | 110–170 | 0.7313 |
Type 2 diabetes mellitus (Presence/Absence) | 22.9%/77.1% (11/37) | N/A | 16.7%/83.3% (9/45) | N/A | 100.0%/0.0% (13/0) | N/A | <.0001 |
Hypertension (Presence/Absence) | 31.3%/68.8% (15/33) | N/A | 38.9%/61.1% (21/33) | N/A | 53.9%/46.2% (7/6) | N/A | 0.3121 |
Dyslipidemia (Presence/Absence) | 20.8%/79.2% (10/38) | N/A | 25.9%/74.1% (14/40) | N/A | 53.9%/46.2% (7/6) | N/A | 0.0574 |
Colorectal cancer in first-degree relatives | 6.3% (3/48) | N/A | 3.7% (2/54) | N/A | 15.4% (2/13) | N/A | 0.2858 |
Fatty liver index (≤60/>60) | 54%/46% (26/22) | N/A | 63%/37% (34/20) | N/A | 69%/31% (9/4) | N/A | 0.4559 |
NAFLD fibrosis score (F0–F2/indeterminant score/ F3-F4) | 71%/27%/2% (34/13/1) | N/A | 74%/24%/2% (40/13/1) | N/A | 15%/77%/8% (2/10/1) | N/A | 0.0019 |
FIB-4 index | 1.15 (0.91–1.56) | 0.53–3.67 | 1.16 (0.90–1.53) | 0.20–3.67 | 1.81 (1.36–2.01) | 0.53–2.90 | 0.1427 |
Platelet count (×104/µL) | 22 (18–27) | 12–37 | 25 (20–27) | 12–85 | 18 (16–24) | 12–37 | 0.2141 |
AST (U/L) | 23 (20–28) | 16–77 | 23 (20–27) | 15–77 | 25 (21–26) | 17–42 | 0.8104 |
ALT (U/L) | 27 (20–38) | 11–107 | 26 (19–34) | 13–107 | 23 (18–30) | 14–44 | 0.3305 |
Lactate dehydrogenase (U/L) | 162 (146–185) | 132–238 | 166 (149–196) | 132–238 | 174 (157–218) | 145–238 | 0.1820 |
ALP (U/L) | 203 (174–265) | 132–422 | 213 (186–264) | 137–422 | 238 (165–337) | 144–422 | 0.4717 |
GGT (U/L) | 43 (24–73) | 13–281 | 40 (24–68) | 12–281 | 24 (17–54) | 14–151 | 0.6126 |
Albumin (g/dL) | 4.5 (4.2–4.7) | 3.9–5.1 | 4.5 (4.2–4.7) | 3.4–5.1 | 4.3 (4.0–4.7) | 3.2–4.9 | 0.3471 |
Total bilirubin (mg/dL) | 0.9 (0.6–1.0) | 0.3–2.0 | 0.8 (0.7–1.0) | 0.3–2.0 | 0.9 (0.8–1.1) | 0.6–1.1 | 0.9535 |
HDL cholesterol (mg/dL) | 54 (43–63) | 33–92 | 56 (43–74) | 33–93 | 55 (46–65) | 38–82 | 0.4955 |
Triglycerides (mg/dL) | 146 (105–248) | 31–440 | 141 (89–202) | 34–760 | 139 (84–182) | 73–352 | 0.8513 |
Fasting glucose (mg/dL) | 103 (97–112) | 67–230 | 103 (96–111) | 67–141 | 125 (108–148) | 67–230 | 0.0003 |
HbA1c (%) | 5.7 (5.4–6.1) | 5.0–8.8 | 5.6 (5.4–5.9) | 5.0–7.1 | 6.5 (6.2–7.0) | 5.2–8.8 | <0.0001 |
CRP (mg/dL) | 0.10 (0.06–0.14) | 0.03–0.31 | 0.10 (0.06–0.13) | 0.01–0.31 | 0.10 (0.06–0.13) | 0.04–0.29 | 0.8466 |
Colorectal adenomas (Presence/Absence) | 54.2%/45.8% (26/22) | N/A | 53.7/46.3 (29/25) | N/A | 38.5%/61.5% (5/8) | N/A | 0.5750 |
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Fukunaga, S.; Nakano, D.; Kawaguchi, T.; Eslam, M.; Ouchi, A.; Nagata, T.; Kuroki, H.; Kawata, H.; Abe, H.; Nouno, R.; et al. Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study. Int. J. Mol. Sci. 2021, 22, 5462. https://doi.org/10.3390/ijms22115462
Fukunaga S, Nakano D, Kawaguchi T, Eslam M, Ouchi A, Nagata T, Kuroki H, Kawata H, Abe H, Nouno R, et al. Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study. International Journal of Molecular Sciences. 2021; 22(11):5462. https://doi.org/10.3390/ijms22115462
Chicago/Turabian StyleFukunaga, Shuhei, Dan Nakano, Takumi Kawaguchi, Mohammed Eslam, Akihiro Ouchi, Tsutomu Nagata, Hidefumi Kuroki, Hidemichi Kawata, Hirohiko Abe, Ryuichi Nouno, and et al. 2021. "Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study" International Journal of Molecular Sciences 22, no. 11: 5462. https://doi.org/10.3390/ijms22115462