Original article
Alimentary tract
Association of Obesity With Colonic Diverticulosis in Women

https://doi.org/10.1016/j.cgh.2019.04.058Get rights and content

Background & Aims

Obesity has been associated with an increased risk of colonic diverticulosis. Evidence for this association is limited. We assessed whether anthropometric measures of obesity were associated with colonic diverticulosis.

Methods

We analyzed data from a prospective study of 623 patients undergoing screening colonoscopies from 2013 through 2015; colonoscopies included examinations for diverticulosis. Body measurements were made the day of the procedure. Multivariate analyses were performed using modified Poisson regression to estimate prevalence ratios (PRs) and 95% CIs while adjusting for confounding variables. All analyses were stratified by sex.

Results

Among men, there was no association between any measure of obesity and diverticulosis. After adjustment, women with an obese body mass index (BMI ≥ 30) had an increased risk of any diverticulosis (PR, 1.48; 95% CI, 1.08–2.04) compared with women with a normal body mass index (BMI 18.5–24.9). The strength of this association was greater for more than 5 diverticula (PR, 2.05; 95% CI, 1.23–3.40). There was no significant association between measures of central obesity and diverticulosis in women. Stratified by sex, colonic diverticulosis was significantly less prevalent in women compared with men before the age of 51 years (29% vs 45%, P = .06). The prevalence of diverticulosis did not differ by sex in older age groups.

Conclusions

In an analysis of data from 623 patients undergoing screening colonoscopies, we found that obesity (BMI ≥30) significantly increased the risk of colonic diverticulosis in women but not men. Colonic diverticulosis was less prevalent in premenopausal-age women compared with similar-age men. These findings suggest that sex hormones may influence the development of diverticulosis.

Section snippets

Materials and Methods

Using data from a colonoscopy-based study of colonic diverticulosis (National Institutes of Health R01DK094738), we assessed whether anthropometric measures were associated with diverticulosis. The study recruited outpatients 30 years of age and older presenting for a screening colonoscopy at the University of North Carolina Hospital in Chapel Hill between 2013 and 2015. The study included patients with a complete examination to the cecum and at least a satisfactory preparation for a screening

Results

Our analysis included 623 participants; 56% were women. The prevalence of diverticulosis increased with age (Figure 1). Before 51 years of age, colonic diverticulosis was less prevalent in women (29%) compared with men (45%) (P = .06) (Figure 1). In the group of individuals 51–60 years old, the prevalence of colonic diverticulosis in women was 37% and in men 43% (P = .31). After 60 years of age, colonic diverticulosis was equally prevalent in women (55%) and men (57%) (P = .90). Women with

Discussion

In this prospective colonoscopy-based study, general obesity was significantly associated with the risk of colonic diverticulosis among women, but not among men. These associations were dose-dependent and stronger when considering >5 diverticula. We also found that premenopausal age women appear to be protected from diverticulosis compared with age-comparable men. There was no difference in the prevalence of diverticulosis by sex after 50 years of age .

Previous studies in Western populations

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    Conflicts of interest The authors disclose no conflicts.

    Funding This research was supported in part by grants from the National Institutes of Health K23DK113225, R01DK09473, and P30 DK034987

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