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地理和季节性差异与憩室炎入院的关联。

Association of geographic and seasonal variation with diverticulitis admissions.

机构信息

Department of Surgery, Massachusetts General Hospital, Boston.

Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

出版信息

JAMA Surg. 2015 Jan;150(1):74-7. doi: 10.1001/jamasurg.2014.2049.

Abstract

IMPORTANCE

The incidence of diverticulitis has been associated with geographic and seasonal variation. Low levels of circulating vitamin D are associated with diverticulitis. We investigated the association between UV light and diverticulitis.

OBSERVATIONS

We identified nonelective diverticulitis admissions in the Nationwide Inpatient Sample and linked hospital locations to UV data. We examined UV exposure in relation to risk of admission for diverticulitis. We identified geographic and seasonal trends among 226 522 nonelective admissions for diverticulitis. Compared with high-UV areas, low-UV areas had a higher rate of diverticulitis (751.8 vs 668.1 per 100 000 admissions; P < .001), diverticular abscess (12.0% vs 9.7%; P < .001), and colectomy (13.5% vs 11.5%; P < .001). We also observed significant seasonal variation, with a lower rate of diverticulitis in the winter (645 per 100 000) compared with the summer (748 per 100 000) (P < .001). The summer increase was more evident in areas with the greatest UV fluctuation vs areas with the least UV fluctuation (120 vs 70 per 100 000; P = .01).

CONCLUSIONS AND RELEVANCE

Low UV light exposure is associated with an increased rate of diverticulitis admissions and greater seasonal variation. Because UV exposure largely determines vitamin D status, these findings support a role for vitamin D in the pathogenesis of diverticulitis.

摘要

重要性

憩室炎的发病率与地理和季节变化有关。循环中维生素 D 水平低与憩室炎有关。我们研究了紫外线与憩室炎之间的关系。

观察结果

我们在全国住院患者样本中确定了非选择性憩室炎入院病例,并将医院位置与紫外线数据相关联。我们检查了紫外线暴露与憩室炎入院风险的关系。我们在 226522 例非选择性憩室炎入院病例中发现了地理和季节趋势。与高紫外线地区相比,低紫外线地区的憩室炎发病率更高(751.8 比 668.1/100000 人;P<0.001),憩室脓肿(12.0%比 9.7%;P<0.001)和结肠切除术(13.5%比 11.5%;P<0.001)。我们还观察到显著的季节性变化,冬季憩室炎的发病率较低(645/100000),夏季发病率较高(748/100000)(P<0.001)。在紫外线波动最大的地区与紫外线波动最小的地区相比,夏季的增加更为明显(120 比 70/100000;P=0.01)。

结论和相关性

低紫外线暴露与憩室炎入院率增加和季节性变化更大有关。由于紫外线暴露在很大程度上决定了维生素 D 状态,这些发现支持维生素 D 在憩室炎发病机制中的作用。

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