Association of nonalcoholic fatty liver disease with the risk of colorectal adenoma and colorectal cancer: A Meta-analysis

ObjectiveTo systematically evaluate the association of the presence and severity of nonalcoholic fatty liver disease (NAFLD) with the risk of colorectal adenoma (CRA) and colorectal cancer (CRC). MethodsPubMed, Embase, Web of Science, The Cochrane Library, CNKI, Wanfang Data, and VIP databases were searched for Chinese and English articles on the association of NAFLD with CRA and CRC published up to December 2019. Secondary screening, quality assessment, and data extraction were performed according to inclusion and exclusion criteria, and RevMan 5.3 software was used to perform the meta-analysis. ResultsA total of 3 longitudinal cohort studies and 18 cross-sectional studies were included, with 130 271 subjects in total. The meta-analysis showed that NAFLD patients had an increased risk of CRA (adjusted odds ratio ［aOR］=1.27, 95% confidence interval ［CI］: 1.18-1.36, P＜0.000 01) and advanced CRA/CRC (aOR=1.45, 95%CI: 1.27-1.65, P＜0.000 01). The severity of NAFLD affected such association, and patients with nonalcoholic steatohepatitis and/or advanced liver fibrosis had a significant increase in the risk of CRA/CRC (aOR=1.93, 95%CI: 1.61-231, P＜0.000 01). ConclusionThe presence of NAFLD is associated with an increased risk of CRA and CRC, and the higher the severity of NAFLD, the higher the risk of CRA and CRC