Body Mass Index and Diverticular Disease: A 28-Year Follow-Up Study in Men

Department of Surgery, Sahlgrenska University Hospital/Ostra, SE-416 85, Göteborg, Sweden.
Diseases of the Colon & Rectum (Impact Factor: 3.75). 05/2008; 51(4):450-5. DOI: 10.1007/s10350-007-9172-5
Source: PubMed


Diverticular disease increased steadily concomitant with elevated rates of overweight and obesity during the 20th century. Therefore, the objective of this study was to investigate whether overweight and obesity in midlife predict future diverticular disease in men.
This was a prospective cohort study of a general population of men living in Göteborg, Sweden. A community-based sample of 7,494 men, investigated when aged 47 to 55 years, were followed from baseline in 1970 to 1973 for a maximum of 28 years. Hospitalization with a discharge diagnosis of diverticular disease according to the Swedish hospital discharge register was measured.
Totally, 112 men (1.5 percent) were hospitalized with diverticular disease. A relationship between body mass index and diverticular disease was demonstrated; men with a body mass index between 20 and 22.5 kg/m2 had the lowest risk. After adjustment for covariates, the risk increased linearly in men who had a body mass index of 22.5 to 25 (multiple-adjusted hazard ratio, 2.3; 95 percent confidence interval, 0.9-6; 25-27.5 (hazard ratio, 3 (1.2-7.6)), 27.5-30 (hazard ratio 3.2, (1.2-8.6)), and 30 or greater (hazard ratio 4.4, (1.6-12.3)) kg/m2 (P for linear trend = 0.004). Men with a body mass index of < or =20 kg/m2 had a nonsignificantly elevated risk (hazard ratio, 3 (0.7-12.5)). Smoking (hazard ratio, 1.6 (1.1-2.3) and diastolic blood pressure (hazard ratio, 1.02 (1.01-1.04) per mmHg) also were independently related to risk of diverticular disease.
In a large community-based sample of middle-aged men, overweight and obesity were strongly linked to future severe diverticular disease leading to hospitalization.

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    • "Asociación entre obesidad y sobrepeso con enfermedad diverticular complicada del colon, según diferentes autores Autor y año País Tipo de estudio Método de medición Conclusiones Dobbins et al. 13 (2006) Australia Retrospectivo IMC Los pacientes con diverticulitis recurrente y perforación, son significativamente más obesos que los asintomáticos y aquellos con un sólo episodio (p = 0,001 y p = 0,002) Rosemar et al. 14 (2008) Suecia Cohorte prospectivo IMC El sobrepeso y la obesidad se correlacionan con un myor incidencia de diverticulitis, que requiere de hospitalización (RR de 3 a 4.4) Strate et al. 12 (2009) Estados Unidos Cohorte prospectivo IMC, circunferencia de la cintura, y proporción cintura-cadera El sobrepeso y la obesidad se asociaron con una mayor incidencia de diverticulitis y hemorragia ( RR 1,78 y 3,19) Jeong et al. 15 (2011) Korea Retrospectivo IMC, medición de grasa visceral mediante TAC La obesidad visceral se asocia de manera significativa con enfermedad diverticular complicada (p = 0,032) Yamada et al. 16 (2013) Japón Retrospectivo IMC, medición de grasa visceral mediante TAC La obesidad visceral se asocia de manera significativa con diverticulitis izquierda (p = 0,0390) "
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    ABSTRACT: The incidence of diverticular disease of the colon has been rising in recent years, and the associated factors are: low ingestion of fibre, age, lack of physical activity, and obesity. A retrospective, descriptive, observational study was conducted on patients with the diagnosis of complicated diverticular disease requiring surgical or interventional treatment, for a period of 12 years. A total of 114 patients (72 males, and 42 females), age range 28-91 years. More than three-quarters (88 patients; 77.19%) had a body mass index (BMI) between 25 and 40 kg/m(2), and 26 patients (22.8%) had a BMI between 20 and 25 kg/m(2). Among the patients with BMI less than 25 kg/m(2), 12 patients had Hinchey 1 (46%), 8 Hinchey 2 (30.7%), 4 Hinchey 3 (15.4%), and two Hinchey 4 (7.7%). Of the patients with BMI greater than 25 kg/m(2), 19 patients had Hinchey 1 (21.6%), 24 Hinchey 2 (27.3%), 27 Hinchey 3 (30.7%), and 18 Hinchey 4 (20.45%). A statistically significant difference (P<0.001) was found between groups using Mann-Whitney U test. The BMI greater than 25 kg/m(2) as risk factor for complicated diverticular disease showed Odds Ratio of 3.4884 (95% confidence interval 1.27-9.55) with Z value of 2.44 (P=0.014). In this study, obesity was associated with an increased incidence and severity of complicated diverticular disease. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
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    • "Thus far, some studies showed the correlation between obesity and diverticulitis (Table 5).13,14,20,41 However, most studies were conducted in Western countries. "
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