engleski

Risk Factors for Colorectal Adenoma – Acknowledging the Burden of NAFLD

Global trends of diet have changed in Western and Eastern countries, featuring foods that are highly processed, contain saturated fat and carry excessive carbohydrate calories. This, accompanied by lower levels of physical activity, due to a more sedentary lifestyle, and the overweight/obesity epidemic, is the reason we are facing a rise in occurrence of new cases of metabolic syndrome. Furthermore, patients are at substantial risk of developing the well-known complications related to each of the components of metabolic syndrome, those being insulin resistance/diabetes mellitus, arterial hypertension, hyperlipidemia and visceral obesity.1 Nonalcoholic fatty liver disease (NAFLD), traditionally regarded as a liver presentation of metabolic syndrome, represents a wide spectrum of liver conditions, ranging from liver steatosis through nonalcoholic steatohepatitis and advanced liver diseases, such as decompensated cirrhosis and hepatocellular carcinoma. NAFLD is also recognized as a risk factor for extrahepatic gastrointestinal (colon, esophagus, stomach, pancreas) and extraintestinal sites of malignancies (kidney in men, breast in women). Patients with NAFLD present with insulin resistance, namely higher levels of circulating insulin effect the insulin/insulin-like growth factor axis that affects cell growth through a potentially carcinogenic pathway, and generally express an adipocytokine profile that promotes a chronic proinflammatory state.2 This could represent a link between obesity and promotion of gastrointestinal cancers but more studies are needed to clearly define the entire pathological pathway

colorectal carcinoma, risk factors, NAFLD

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