title: Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp.
abstract: Aim. Our study aims to determine possible association between biopsy-proven nonalcoholic steatohepatitis (NASH) and hyperplastic polyps (HP) of the colon.Methods. A retrospective cohort observational study. All subjects underwent screening colonoscopy within two years. Data were extracted from the patient charts including demographic, anthropometric measurement, vital signs, underlying diseases, medical therapy, laboratory data, results of the liver biopsy with degree of fibrosis and necroinflammatory activity, the colonoscopy report, and the pathological report of the extracted polyp.Results. A total of 223 patients were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group matched for age. 14 colonic adenomas (11% of patients) were found in the NASH group compared with 16 adenomas (16% of patients) found in the control group (P= 0.9). 28 HPs were found in the NASH group (22.7%) compared with only 8 HPs in the control group (8%) (P< 0.05). 21 from the 28 (75%) HPs diagnosed in the NASH group were observed in the high degree fibrosis patients (Fibrosis Stages 3 and 4), 6 HPs (21%) were associated with Fibrosis Stages 1 and 2, and single HP (4%) was associated with Fibrosis Stage 0.Conclusions. Our study showed an association between biopsy-proven steatohepatitis and the burden of hyperplastic polyp. The severity of hepatic fibrosis may play important role in the increased occurrence of HPs.
authors.affiliation: Internal Medicine Department, Holy Family Hospital, Nazareth, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
authors.forename: Mahmud
authors.identifier: 0000-0001-5772-9052
authors.initials: M
authors.lastname: Mahamid
authors.affiliation: Internal Medicine Department, Holy Family Hospital, Nazareth, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
authors.forename: Omar
authors.initials: O
authors.lastname: Abu-Elhija
authors.affiliation: Internal Medicine Department, The Baruch Padeh Medical Center, Poriya, Israel.
authors.forename: Tarik
authors.initials: T
authors.lastname: Yassin
authors.affiliation: Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; Internal Medicine Department, EMMS the Nazareth Hospital, Nazareth, Israel.
authors.forename: William
authors.identifier: 0000-0003-4091-6948
authors.initials: W
authors.lastname: Nseir
mesh_terms: D000236:Adenoma / Q000453:epidemiology*; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology*; D003111:Colonic Polyps / Q000453:epidemiology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies