| Background:Nonalcoholic fatty liver disease(NAFLD)is one of the most important public health problems in the world,with insulin resistance(IR)based metabolic syndrome(MS)involving the liver.Recent studies have shown that both MS and NAFLD are associated with high rates of colorectal cancer(CRC).Intestinal polyps as an important precancerous lesion,may have some common mechanisms and risk factors for gastric polyps.Objective: To investigate the correlation between NAFLD and gastrointestinal polyps and its influencing factors,aiming at improving the detection rate of gastrointestinal polyps in NAFLD patients.Methods:(1)265 patients with complete colonoscopy were divided into experimental group and control group according to the presence or absence of NAFLD,and divided into subgroups according to gender.The clinical data were analyzed by chi-square test and T-test of independent samples.The morphological,distribution and pathological types of colorectal polyps were compared between groups.The risk factors of colorectal polyps and their correlation with MS components were also discussed.(2)341 patients with complete endoscopy were divided into experimental group and control group according to the presence or absence of NAFLD.The clinical data and laboratory data were analyzed by chi-square test and T-test of independent samples.To compare the detection rate of upper gastrointestinal polyps and the size,shape,distribution and pathological type of polyps in the two groups.To explore the risk factors of upper gastrointestinal polyps and their correlation with MS.(3)236 patients who underwent simultaneous gastrointestinal examination were grouped according to the presence or absence of gastrointestinal polyps.The incidence of colorectal polyps and the size,morphology,distribution and pathological types of colonic polyps were compared between the two groups.The risk factors of gastrointestinal polyps and the correlation with MS components were also discussed.Results:(1)In the male patients,the detection rate of colonic polyps was significantlyhigher in the NAFLD group(70.1% vs 44.8%,P = 0.003),and the polyp diameter(1.2 ± 0.6 vs 0.9 ± 0.4,P = 0.026),the proportion of polyp(72.3% vs 63.3%,P =0.013)was significantly higher than that of the control group.In female patients,the detection rate of colonic polyps was significantly higher in the NAFLD group than in the control group(55.3% vs 34.5%,P = 0.024),the number of polyps was more(1.9 ±2.1 vs 1.1 ± 1.5,P = 0.008)and larger(1.1 ± 0.4 vs 0.8 ± 0.4,P = 0.030),but no increase in the proportion of adenomatous polyps.Spearman correlation analysis showed that colorectal polyps were closely related to waist circumference(WC),triglyceride(TG),liver controlled decay parameters(CAP),elasticity(E)and fatty liver severity in male patients,and mainly associated with WC,total cholesterol(TC)and NAFLD and their severity in female patients.Multivariate logistic regression analysis showed that hypertension(OR: 2.412,95% CI: 1.074-5.416,P = 0.033),NAFLD(OR: 3.268,95% CI: 1.444-7.394,P = 0.004)were risk factors for colorectal polyps in male patients.NAFLD was an independent risk factor for colorectal polyps(OR: 2.670,95% CI: 1.134-6.290,P = 0.025)in female patients.(2)The detection rate of upper gastrointestinal polyps in NAFLD group was no significant difference with that in control group(30.9% vs 23.0%,P = 0.476).The proportion of multiple polyps in NAFLD group was higher than that in NAFLD group(47.6% vs,26.8%,P=0.033),and pedunculated polypsmore common(Yamada III,IV).However,there was no significant difference in the size and distribution of upper gastrointestinal polyps and the infection of Helicobacter pylori(Hp)between the two groups(P > 0.05).On the other hand,HOMA-IR(HOMA steady-state model)and the detection rate of NAFLD in of upper gastrointestinal polyps were increased.Spearman correlation analysis showed that the upper gastrointestinal polyps associated with age,gender,and the prevalence rate of hypertension and diabetes,fasting blood glucose(FPG),HOMA-IR,gamma glutamyl transferase(GGT),creatinine(Cr),fatty liver index(FLI)was positively related.In terms of gastric polyps,there was no significant difference between the NAFLD group and the control group in the location,diameter and pathological types of polyps.There was a tendency of multiple and pedicle of gastric polyps in NAFLD group.Compared with the control group,NAFLD patients with IRwere more likely to develop polyps in the antrum(P = 0.008).The diameter of the patient’s gastric polyps is associated with FPG,GGT,and hypertension and diabetes.Multivariate logistic regression analysis showed that gender,age,and diabetes were risk factors for upper gastrointestinal polyps.(3)The detection rate of colorectal polyps in patients with gastric polyps is no higher than that of the control group without gastric polyps,but age,CAP value(in severe fatty liver)and the detection rate of hypertension and NAFLD of patients with gastrointestinal polyps were significantly increased.In terms of FT detection,compared with the colorectal polyps group,gastrointestinal polyps were more common in the left colon(P=0.048),and were more likely to have a flat sessile polyp(Yamada type I and type II)(P=0.009).Conclusion: NAFLD and its severity are closely related to the detection rate and diameter of colorectal polyps.The polyps of male NAFLD patients are mostly adenomatous polyps,and the polyps of female NAFLD patients have multiple characteristics.NAFLD and gastric polyps have a certain relevance,such polyps have multiple and pedicle tendencies;IR patients with NAFLD more prone to gastric antrum polyps.Gastric polyps do not increase the detection rate of colorectal polyps.For gastrointestinal polyps,NAFLD and its severity and the prevalence of hypertension increased,and the left colon colon polyp polyps more common. |
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