| Objectives: To investigate and analyze the prevalence and risk factors of fatty liver in a physical examination population in Xi’an,to explore the correlation between fatty liver index(FLI)and colorectal adenoma,and to evaluate the clinical value of FLI as a screening index of colorectal adenoma,so as to provide basis for the prevention and treatment of fatty liver and early screening and treatment of colorectal adenoma.Methods: This study is divided into two parts.In the first part,9096 healthy people with complete physical examination data in the Third Hospital of Xi’an from June 2017 to June 2019 were selected,and anthropometric indexes,biochemical indicators and abdominal ultrasound results were collected.According to the results of abdominal ultrasound,the subjects were divided into groups,and the prevalence of fatty liver was compared by age and gender;The two groups were compared by gender;The incidence of concomitant diseases was compared between the two groups;the risk factors of fatty liver was analyzed.According to body mass index,the subjects were divided into obesity group,overweight group,normal weigh and lean group,and the prevalence of fatty liver was compared among the three groups.In the second part,520 physical examinees in the Third Hospital of Xi’an and Xi’an Central Hospital from January 2019 to December 2020 were selected.The general physical examination indexes,biochemical indicators,abdominal ultrasound and colonoscopy results of the subjects were collected,and the fatty liver index of the subjects was calculated.The subjects were divided into two groups according to the results of colonoscopy and pathology;Objective to analyze the risk factors of colorectal adenoma and its correlation with MAFLD and FLI;Objective to evaluate the application value of FLI in screening colorectal adenoma and find the best cut-off value.Results:1.Prevalence and risk factors of fatty liver in physical examination population.1.1 The prevalence of fatty liver: among 9096 subjects,the prevalence rate of fatty liver was 25.18%.The prevalence rate of male was significantly higher than that of female;the prevalence rate of female aged 60-69 was the highest,and that of male aged30-39 was the highest.1.2 Comparison of various indexes: the levels of body mass index(BMI),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL),fasting blood glucose(FPG),serum uric acid(UA),systolic blood pressure(SBP),diastolic blood pressure(DBP)in fatty liver group were significantly higher than those in non fatty liver group,and the level of high density lipoprotein cholesterol(HDL)was significantly lower than that in non fatty liver group(P < 0.01);1.3 Detection of overweight and obesity: the detection rates of overweight and obesity were 36.09% and 12.51% respectively.The prevalence of fatty liver in overweight and obesity group was significantly higher than that in normal weight group and lean group(P < 0.01).1.4 Comparison of concomitant diseases between the two groups: the prevalence rates of hypertension,diabetes,dyslipidemia,hyperuricemia and gallbladder diseases in fatty liver group were significantly higher than those in non fatty liver group(P < 0.001).1.5 Multivariate logistic regression analysis of fatty liver: age,BMI,DBP,FPG,TG,TC,UA,gallbladder disease are the risk factors of fatty liver;HDL is the protective factor of fatty liver.2.The relationship between fatty liver index and colorectal adenoma2.1 Population basic information: In 520 subjects,male to female ratio was 1.02:1,the average age was 48.69±5.65 years old.A total of 125 patients with colorectal adenoma were detected,the prevalence rate was 24.04%,and the median FLI was 21.91.2.2 Comparison of the indexes between the two groups: age,BMI,abdominal circumference,SBP,DBP,albumin,alanine aminotransferase,aspartate aminotransferase,glutamyltranspeptidase,TC,TG,HDL,UA,FPG,carcinoembryonic antigen and FLI in colorectal adenoma group were higher than those in the control group,while HDL in colorectal adenoma group was lower than that in the control group(P < 0.05);2.3 Comparison of the prevalence of colorectal adenoma: the prevalence of colorectal adenoma in male(38.93%)was significantly higher than that in female(8.91%);the prevalence of colorectal adenoma in metabolic associated fatty liver disease(MAFLD)group(50.63%)was significantly higher than that in non mafld group(12.43%),the difference was statistically significant(P < 0.01).2.4 Correlation analysis of colorectal adenoma with MAFLD and FLI: colorectal adenoma was positively correlated with MAFLD and fatty liver index(P < 0.01).2.5 Multivariate logistic regression analysis of colorectal adenoma: male,MAFLD and FLI were risk factors of colorectal adenoma.2.6 Application value and best cut-off point of FLI in screening colorectal adenoma:the area under ROC curve of FLI in screening colorectal adenoma was 0.848(95% CI:0.806-0.890).When FLI≥32.07 was used as the cut-off point of screening colorectal adenoma,the sensitivity and specificity were both high,which were 0.864 and 0.749,respectively.Conclusions:1.The prevalence rate of fatty liver in a physical examination population in Xi’an city was 25.18%,which was in the middle level in China.2.The prevalence rate of fatty liver in male is higher than that in female,and there are differences among different age groups.3.The detection rate of overweight and obesity was 36.09% and 12.51%respectively.4.Overweight and obesity,hypertension,type 2 diabetes,dyslipidemia,hyperuricemia and gallbladder disease are the risk factors of fatty liver.5.There is a significant positive correlation between MAFLD,FLI and colorectal adenoma.6.FLI has high clinical value for colorectal adenoma screening,and the best cut-off point is 32.07. |
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