Association Between Obesity and Weight Change and Risk of Diverticulitis in Women

Ma, Wenjie; Jovani, Manol; Liu, Po Hong; Nguyen, Long H.; Cao, Yin; Tam, Idy; Wu, Kana; Giovannucci, Edward; Strate, Lisa L.; Chan, Andrew T.

doi:10.1053/j.gastro.2018.03.057

Cited by 52 publications

(46 citation statements)

References 37 publications

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“…The aim of our present study was to assess the role of genetic variations consistently identified in the three large recent GWAS 10,12,13 for the specific risks for diverticulosis and diverticulitis, respectively. Our results are in line with previous data concerning the association of diverticulosis with age and BMI as risk factors (diverticulosis) [22][23][24] , as well as alcohol consumption 25,26 and smoking status [27][28][29] as risk factors for diverticulitis.…”

Section: Discussionsupporting

confidence: 93%

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Reichert

Kupčinskas

Schulz

et al. 2020

Sci Rep

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colonic diverticulosis is a very common condition. Many patients develop diverticulitis or other complications of diverticular disease. Recent genome-wide association studies (GWAS) consistently identified three major genetic susceptibility factors for both conditions, but did not discriminate diverticulititis and diverticulosis in particular due the limitations of registry-based approaches. Here, we aimed to confirm the role of the identified variants for diverticulosis and diverticulitis, respectively, within a well-phenotyped cohort of patients who underwent colonoscopy. Risk variants rs4662344 in Rho GTPase-activating protein 15 (ARHGAP15), rs7609897 in collagen-like tail subunit of asymmetric acetylcholinesterase (COLQ) and rs67153654 in family with sequence similarity 155 A (FAM155A) were genotyped in 1,332 patients. Diverticulosis was assessed by colonoscopy, and diverticulitis by imaging, clinical symptoms and inflammatory markers. Risk of diverticulosis and diverticulitis was analyzed in regression models adjusted for cofactors. Overall, the variant in FAM155A was associated with diverticulitis, but not diverticulosis, when controlling for age, BMI, alcohol consumption, and smoking status (oR adjusted 0.49 [95% CI 0.27-0.89], p = 0.002). Our results contribute to the assessment specific genetic variants identified in GWAS in the predisposition to the development of diverticulitis in patients with diverticulosis. Colonic diverticulosis is a widespread gastrointestinal condition described as formation of diverticula, which are sac-like protrusions of mucosa and submucosa through muscularis externa 1,2. Although diverticulosis is predominantly asymptomatic, many patients develop symptoms 3,4. These manifestations are classified as uncomplicated and complicated diverticular disease (DD), an inflammation of the tissue (diverticulitis) or diverticular bleeding. The prevalence of the disease and its complications is constantly increasing due to the aging populations 5,6. Therefore, the identification of underlying pathobiological mechanisms of the disease is relevant for improving everyday clinical practice. It is hypothesized that environmental factors together with structural alteration of the colonic wall and remodeling of the enteric nervous system are all predisposing components in the development of colonic diverticula 5. In recent years, epidemiological twin data have suggested that genetic factors are another major cofactor in the pathogenesis of DD 7,8. Up to date, there has been relatively little research effort to determine these genes and their sequence variants that are associated with the development of DD 9. Recently an Icelandic study group published a genome-wide association study (GWAS) searching for sequence variants that affect the

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Section: Discussionsupporting

confidence: 93%

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Reichert

Kupčinskas

Schulz

et al. 2020

Sci Rep

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“…37,38 Obesity, and central obesity in particular, increases the risk of diverticulitis. [39][40][41][42] Smoking is also associated with an increased risk of diverticulitis-particularly complicated diverticulitis. [43][44][45][46] On the other hand, dietary fiber intake and prudent diets (high in fruits, vegetables, and whole grains) reduce the risk of diverticulitis.…”

Section: Risk Factorsmentioning

confidence: 99%

Epidemiology, Pathophysiology, and Treatment of Diverticulitis

2019

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“…The sixth and the seventh statement point out that diverticulosis is a merely expression of an anatomical alteration [21][22][23], while symptomatic uncomplicated diverticular disease (SUDD) may have overt inflammation microscopic inflammation even without any endoscopic inflammation [24,25]. The last two statements point out the role of high fiber diet in reducing the risk of acute diverticulitis [26][27][28][29][30], and more recent evidences are available about the role of obesity on occurrence of DD complications [31,32]. Overall consensus about these statement was very high, since all of them reached >80% agreement among respondents.…”

Section: Commentsmentioning

confidence: 99%

International Consensus on Diverticulosis and Diverticular Disease. Statements from the 3rd International Symposium on Diverticular Disease

Tursi

Brandimarte

Mario

et al. 2020

JGLD

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The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.

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Association Between Obesity and Weight Change and Risk of Diverticulitis in Women

Abstract: During a 6-year follow-up period, we observed an association between obesity and risk of diverticulitis among women. Weight gain during adulthood was also associated with increased risk.

Cited by 52 publications

References 37 publications

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Common variation in FAM155A is associated with diverticulitis but not diverticulosis

Epidemiology, Pathophysiology, and Treatment of Diverticulitis

International Consensus on Diverticulosis and Diverticular Disease. Statements from the 3rd International Symposium on Diverticular Disease

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