Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study

Background Colorectal cancer is known to be an extrahepatic complication of non-alcoholic fatty liver disease (NAFLD). However, the interaction of NAFLD with obesity for incident colorectal cancer has not been clarified yet. Moreover, the effect of NAFLD and obesity for incident gastric cancer has n...

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Main Authors: Michiaki Fukui, Masahide Hamaguchi, Yoshitaka Hashimoto, Akihiro Obora, Takao Kojima
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/6/1/e000295.full
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author Michiaki Fukui
Masahide Hamaguchi
Yoshitaka Hashimoto
Akihiro Obora
Takao Kojima
author_facet Michiaki Fukui
Masahide Hamaguchi
Yoshitaka Hashimoto
Akihiro Obora
Takao Kojima
author_sort Michiaki Fukui
collection DOAJ
description Background Colorectal cancer is known to be an extrahepatic complication of non-alcoholic fatty liver disease (NAFLD). However, the interaction of NAFLD with obesity for incident colorectal cancer has not been clarified yet. Moreover, the effect of NAFLD and obesity for incident gastric cancer has not been clarified yet. Thus, we investigated whether NAFLD with or without obesity would be a risk factor for incident gastric cancer as well as colorectal cancer.Methods The study period was set from 2003 to 2016. NAFLD was diagnosed by abdominal ultrasonography using standardised criteria. We applied the Cox proportional hazards model to investigate the effect of NAFLD with or without obesity at baseline on incident gastric cancer as well as colorectal cancer. Age, sex, lifestyle factors including smoking states, alcohol consumption and exercise, and diabetes were used as covariates.Results During the study period, 27 944 individuals (16 454 men and 11 490 women) were registered in the NAfld in Gifu Area, Longitudinal Analysis study. During the mean (SD) observational period of 2357 (1458) days, incident gastric cancers were diagnosed in 48 individuals (incident rate 0.48 per 1000 person-years) and incident colorectal cancers were diagnosed in 52 individuals (incident rate 0.51 per 1000 person-years). The adjusted HR of NAFLD with obesity for incident gastric cancer was 3.58 (95% CI 1.73 to 7.38, p=0.001) and that for incident colorectal cancer was 2.96 (95% CI 1.73 to 7.38, p=0.003).Conclusion NAFLD with obesity was a risk factor for both incident gastric cancer and colorectal cancer in apparently healthy Japanese individuals.
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spelling doaj-art-06b71231110c4b419f890376166d2fde2025-08-20T02:08:42ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742019-09-016110.1136/bmjgast-2019-000295Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal studyMichiaki Fukui0Masahide Hamaguchi1Yoshitaka Hashimoto2Akihiro Obora3Takao Kojima4Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Gastroenterology, Asahi University Hospital, Gifu, JapanDepartment of Gastroenterology, Asahi University Hospital, Gifu, JapanBackground Colorectal cancer is known to be an extrahepatic complication of non-alcoholic fatty liver disease (NAFLD). However, the interaction of NAFLD with obesity for incident colorectal cancer has not been clarified yet. Moreover, the effect of NAFLD and obesity for incident gastric cancer has not been clarified yet. Thus, we investigated whether NAFLD with or without obesity would be a risk factor for incident gastric cancer as well as colorectal cancer.Methods The study period was set from 2003 to 2016. NAFLD was diagnosed by abdominal ultrasonography using standardised criteria. We applied the Cox proportional hazards model to investigate the effect of NAFLD with or without obesity at baseline on incident gastric cancer as well as colorectal cancer. Age, sex, lifestyle factors including smoking states, alcohol consumption and exercise, and diabetes were used as covariates.Results During the study period, 27 944 individuals (16 454 men and 11 490 women) were registered in the NAfld in Gifu Area, Longitudinal Analysis study. During the mean (SD) observational period of 2357 (1458) days, incident gastric cancers were diagnosed in 48 individuals (incident rate 0.48 per 1000 person-years) and incident colorectal cancers were diagnosed in 52 individuals (incident rate 0.51 per 1000 person-years). The adjusted HR of NAFLD with obesity for incident gastric cancer was 3.58 (95% CI 1.73 to 7.38, p=0.001) and that for incident colorectal cancer was 2.96 (95% CI 1.73 to 7.38, p=0.003).Conclusion NAFLD with obesity was a risk factor for both incident gastric cancer and colorectal cancer in apparently healthy Japanese individuals.https://bmjopengastro.bmj.com/content/6/1/e000295.full
spellingShingle Michiaki Fukui
Masahide Hamaguchi
Yoshitaka Hashimoto
Akihiro Obora
Takao Kojima
Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
BMJ Open Gastroenterology
title Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
title_full Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
title_fullStr Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
title_full_unstemmed Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
title_short Non-alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer: a population-based longitudinal study
title_sort non alcoholic fatty liver disease with obesity as an independent predictor for incident gastric and colorectal cancer a population based longitudinal study
url https://bmjopengastro.bmj.com/content/6/1/e000295.full
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