The association between nonalcoholic fatty liver disease and esophageal, stomach, or colorectal cancer: National population-based cohort study.
Adult
Aged
Colorectal Neoplasms
/ epidemiology
Esophageal Neoplasms
/ epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
/ epidemiology
Prognosis
Republic of Korea
/ epidemiology
Retrospective Studies
Stomach Neoplasms
/ epidemiology
Survival Rate
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
06
08
2019
accepted:
25
11
2019
entrez:
25
1
2020
pubmed:
25
1
2020
medline:
9
4
2020
Statut:
epublish
Résumé
We investigated the association between nonalcoholic fatty liver disease (NAFLD) and gastrointestinal tract cancer in the general population. Retrospective data on individuals aged ≥20 years who received healthcare checkups from January 1, 2009 to December 31, 2009 were analyzed using the National Health Insurance Database in Korea. NAFLD was defined based on the fatty liver index (FLI ≥60). The primary outcome was newly diagnosed esophageal, stomach, or colorectal cancer using ICD-10 codes during follow-up until 31 December 2017. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Among 8,120,674 subjects, 936,159 adults (11.5%) were identified as having NAFLD. Their mean age was 46.7 ± 14.1 years, and 52.1% were male. During the follow-up period (7.2 years), 3,792 esophageal, 57,292 stomach and 68,769 colorectal cancer cases were identified. FLI ≥60 was significantly associated with the development of esophageal (HR 2.10, 95% CI 1.88-2.35), stomach (HR 1.18, 95% CI 1.14-1.22), and colon cancer (HR, 1.23, 95% CI 1.19-1.26) after multivariable adjustment. Compared to subjects without NAFLD, all-cause mortality in patients with esophageal (HR 1.46, 95% CI 1.28-1.67), stomach (HR 1.26, 95% CI 1.18-1.34), and colorectal cancer (HR 1.16, 95% CI 1.10-1.22) was significantly increased in subjects with NAFLD (FLI ≥60). NAFLD defined using FLI was a good predictive indicator for GI tract malignancy and all-cause mortality in the general population. Subjects with NAFLD are needed for active surveillance of esophageal, stomach, and colorectal cancers.
Identifiants
pubmed: 31978054
doi: 10.1371/journal.pone.0226351
pii: PONE-D-19-22169
pmc: PMC6980645
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0226351Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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