Introduction

Several studies have suggested a possible association between hepatic steatosis and colonic adenomas, positioning hepatic steatosis on the list of potential risk factors.

Aims & Methods

Our study aims to investigate the relationship between hepatic steatosis and the development of colonic adenomas. This is an observational study, with both a retrospective and a prospective arm, spamming from 2017 till 2023. Selected patients are those who underwent a Fibroscan and a colonoscopy during the same year. We collected demographic data, medical history, medication intake, and results of both Fibroscan and colonoscopy. Our population was divided in two: population A with a Controlled Attenuation Parameter (CAP)<258 and population B with a CAP³258. The main outcome was the presence of adenomas on colonoscopy.

Results

In total, our analysis included 232 patients. A ROC curve was obtained, determining that a CAP³258 was associated with the presence of adenomas on a colonoscopy with an AUC of 0.630 with a sensitivity and specificity of 65% and 64% respectively. From these 232, 125 patients had a CAP≥258 (53.8%) and 107 patients had a CAP<258 (46.2%). Patients with a CAP³258 more frequently exhibited: hypertension (54% vs 35.7%, p=0.016), diabetes (36% vs 10.7%, p<0.001), and dyslipidemia (70.6% vs 29.8%, p<0.001) compared to those with a CAP<258. The BMI was higher (29.2 vs 26.7, p=0.001) in the group (CAP³258). Finally, adenomas were more frequent (46.4% vs 33.6%, p=0.025) in this same group.
A multivariate analysis was done. The presence of CAP³258 (OR 2.58, p=0.017), diabetes (OR=3.71, p=0.02), and older age (OR=1.04, p=0.017) are associated with the presence of adenomas on colonoscopy.

Conclusion

Hepatic steatosis is independently associated with the presence of adenomas with an OR of 2.58. Therefore, early screening for colorectal cancer might be warranted in patients with hepatic steatosis. Further studies are required to establish hepatic steatosis as a risk factor of colonic adenomas.